Neurology Director jobs in Paramus, NJ

Job Title: Full Time Prior Authorization Specialist

Busy Neurology practice in Ridgewood, NJ providing 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. In addition, we provide long-term care to patients with chronic neurological disorders.

Neurology Group of Bergen County, has opening for full-time Prior-Authorization Specialists that deal with procedures that include high-dollar Injectable Medications which includes BOTOX, Xeomin, etc, for medical conditions, diagnostic procedures including 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. MUST have knowledge of ATHENA.

RESPONSIBILITIES:

• 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 The Neurology Group of Bergen County meets patient’s insurance requirements for reimbursement prior to testing or treatment.
• 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 office staff, physician and/ or APP in the case of denials that will require rescheduling and/or peer-to-peer review by the ordering physician.
• Keeps current on insurance carrier requirements for testing and treatments provided.
• 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 (2-4 years preferred) 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
• Experience in Athena preferred .
• Basic computer knowledge and keyboarding skills
• Medical terminology
• Excellent communication skills
• Customer service experience and strong organizational skills
• Detail-oriented
• Ability to multi-task and work well in a fast-paced setting
• Critical thinking skills and decisive judgment
• Additional duties include, but not limited to training in order to provide coverage and assistance in daily operations of the Business office.
• High school diploma (required), College Preferred

Requirements: Full time position approximately 40 hours/week. NO REMOTE on site only.

Generous benefit package including:

· Health, dental, vision insurance

· 401 K

· Vacation

· Sick time

· Paid Holidays

· Life Insurance

· Long term disability insurance

Job Type: Full-time

Benefits:

• 401(k)
• Health insurance
• Paid time off

Weekly day range:

• Monday to Friday

Experience:

• Insurance verification: 1 year (Preferred)
• Medical billing: 1 year (Preferred)

Work Location: In person