Prior Authorization Specialist

Job Description

Job DescriptionJob Description

DeCoach Recovery Centre, a local leader in addiction recovery, is seeking an experienced prior authorization specialist to work at our corporate headquaters in Sharonville, OH. This role is critical in ensuring the financial health of our organization.

Job Overview: As a Revenue Cycle Specialist / Prior Authorization Specialist, you will be responsible for overseeing the prior authorization process, including billing, collections, and insurance verification. You will work closely with the finance and administrative teams to ensure accurate and timely processing of patient accounts and maximize revenue for the organization.

Key Responsibilities:

1. Manage the end-to-end revenue cycle process, including charge entry, claims submission, payment posting, and collections.
2. Review and verify accuracy of patient demographic and insurance information.
3. Ensure proper coding of diagnoses and procedures according to industry standards and compliance requirements.
4. Investigate and resolve any billing discrepancies or denials from insurance companies.
5. Follow up on unpaid claims and delinquent accounts to optimize collections.
6. Collaborate with clinical and administrative staff to streamline revenue cycle workflows and improve efficiency.
7. Stay updated on changes in healthcare regulations and insurance policies affecting revenue cycle operations.
8. Analyze data related to revenue cycle performance.

Qualifications:

• Associates degree in Healthcare Administration, Finance, Business, or related field preferred.
• Proven experience (2+ years) working in healthcare revenue cycle management or medical billing.
• Strong knowledge of medical billing practices, including CPT and ICD-10 coding.
• Familiarity with insurance verification and prior authorization processes.
• Proficiency in using healthcare billing and accounting software
• Excellent attention to detail and organizational skills.
• Strong analytical and problem-solving abilities.
• Ability to communicate effectively with patients, insurance companies, and internal stakeholders.
• Understanding of HIPAA regulations and patient confidentiality.

Benefits:

• Competitive salary based on experience.
• Medical, Dental, & Vision Heath Insurance
• Company Paid Life Insurance
• Affiliated with the STAR program, assist employees in paying off student loans
• Tuition Reimbursement program
• Paid Time-Off
• 6 paid Holidays off

Join our dedicated team at DeCoach Recovery and contribute to our mission of providing quality addiction treatment services while ensuring financial sustainability through effective revenue cycle management. If you have the required skills and experience, we encourage you to apply and become part of our compassionate and dynamic team.

8-4:30pm