Prior Authorization Specialist

For more than 20 years, we have demonstrated a commitment to delivering exceptional diagnostic services and patient care through our team of dedicated providers and staff. Our doctors work closely with referring physicians to diagnose and treat disorders of the nervous system including diseases of the brain, nerves, muscles and spinal cord. The providers are experts in all areas of neurological treatment and care including Muscular Dystrophy, ALS or Lou Gehrig's Disease, Multiple Sclerosis, Alzheimer's and, Parkinson's Disease, Huntington's Disease, Cerebrovascular Disease, Seizure Disorders and Stroke Symptoms. In addition, we provide long-term care to patients with chronic neurological disorders.

Texas Neurology has openings for full-time Prior-Authorization Specialists working on pre certifications for MRI and infusions. This position includes verification of insurance benefits as it applies to the pre-certification process, obtaining pre-certification and pre-authorization from payers, and counseling patients regarding their financial obligation with regard to the testing/treatment being scheduled, etc.

RESPONSIBILITIES:

• Supports and promotes the mission and strategic vision of the organization
• Supports and promotes the ideal patient experience
• Collects and reviews all patient insurance information and submits prior-authorization form.
• Authorization Specialist are responsible for all aspects of benefit verification and authorization
• Authorization Specialist ensure that Texas Neurology meets patient’s insurance requirements for reimbursement prior to testing or treatment.
• Obtains necessary pre-authorizations from payer.
• Communicates with physician/clinical staff any pre-certification or PA requirements by the patient’s insurance carriers.
• Ensures up-to-date documentation on patient’s account in Electronic Medical Record related to authorization approvals and denials.
• Works with specialty pharmacies as required by patient’s insurance carrier to set up order and delivery of medication.
• Maintains updated referrals and authorizations.
• Communicates with ordering physician and/ or APP in the case of denials that will require rescheduling and/or peer-to-peer review by the ordering physician.
• Contacts patient to notify of termed insurances.
• Keeps current on insurance carrier requirements for testing and treatments provided at Texas Neurology.
• Follows policy and procedures outlined by management to ensure standardization of processes across the clinics.

KNOWLEDGE /SKILLS REQUIRED TO BE SUCCESSFUL IN THIS POSITION:

• Previous experience in pre-authorization/pre-certification and processing of health insurance claims
• Knowledge of insurance and third party payers
• Previous experience with CPT and ICD-10 coding
• Previous eClinicalWorks (eCW) use a plus, but not a requirement
• Basic computer knowledge and keyboarding skills
• Medical terminology
• Excellent communication skills
• Customer service experience
• Strong organizational skills
• Detail-oriented
• Ability to multi-task and work well in a fast-paced setting
• Critical thinking skills and decisive judgment

ENVIRONMENTAL/WORKING CONDITIONS: Combination of office and exam settings. Frequent exposure to communicable diseases, toxic substances, ionizing radiation, medicinal preparations and other conditions common to a clinic environment.

PHYSICAL/MENTAL DEMANDS: Varied activities including standing, walking, reaching, bending, lifting. Requires full range of body motion including handling and lifting patients, manual and finger dexterity and eye-hand coordination. Requires standing and walking for extensive periods of time. Requires corrected vision and hearing to normal range. Requires working under stressful conditions or working irregular hours.

We extend an extremely competitive offering of benefits to employees, including Medical Health Care, Dental Care, and Vision Plan, 401-k with a matching component, Life Insurance, and Wellness Programs. Come join our growing organization and enjoy knowing that you work for an organization dedicated to making the lives of others better. Texas Neurology is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, or national origin.'
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Benefit Conditions:

• Waiting period may apply
• Only full-time employees eligible

Work Remotely

• No

Job Type: Full-time

Pay: From $18.00 per hour

Benefits:

• 401(k)
• 401(k) matching
• Dental insurance
• Disability insurance
• Flexible spending account
• Health insurance
• Health savings account
• Life insurance
• Paid time off
• Vision insurance

Schedule:

• Day shift
• Monday to Friday

COVID-19 considerations:
Texas Neurology requires staff to be vaccinated against COVID-19 in order to protect our patients and employees from infection. If necessary, you can apply for an exemption for medical or religious reasons by contacting Human Resources.

Experience:

• prior authorization: 1 year (Required)
• Insurance verification: 1 year (Required)
• MRI/Infusion: 1 year (Required)

Work Location: In person

Salary : $18 - $0