Jobs in America

Authorization Specialist

California
FULL TIME
1 Year

Is full time work something that you're passionate about? The salary not being disclosed by the employer means you can negotiate it. The job vacancy named Authorization Specialist was posted on January 6, 2024, and it will be closed on April 5, 2024. To be eligible for this job, you need to have work experience in the same field for at least 12 months. This job is situated in California, but it's a remote job that provides the flexibility to work from any location with an internet connection.

Rethink Behavioral Health is the leading global provider of online research-based resources to support individuals with developmental disabilities. Our behavioral health platform (http://RethinkBH.com) provides clinical, staff training and practice management tools for private ABA service providers. Due to autism insurance mandates sweeping the nation, our behavioral health division is experiencing unprecedented growth. Therefore, we are looking for the right person to join our billing service team.

Our Billing Services Division specializes in Revenue Cycle Management and Enrollment and Credentialing services. We are growing and are looking for new team members that will offer our clients best in class billing services. We support mission-oriented companies that impact the lives of thousands of individuals with autism and their families. We are excited to offer the opportunity for professional and collaborative individuals to grow and be part of something exciting.

The Authorization Specialist is responsible for processing Prior-Authorization requests directly with insurance companies to ensure efficient and prompt reimbursement for therapy sessions for our customers supported within the RCM division.

Remote opportunities are available only in the following states: CA, CO, FL, GA, IL, IN, MO, NE, NY, NC, PA & TX

Authorization Responsibilities:

  • Ensure strict HIPAA-compliant confidentiality with all client-related data
  • Contact insurance companies for specific Prior-Authorization process/forms
  • Complete required insurance forms and ensure all supporting documentation is submitted to the insurance companies
  • Follow-up with insurance to confirm receipt and status of Prior-Authorizations
  • Customer communications to update the status of the Prior-Authorizations
  • Update Prior-Authorization Tracker daily
  • Measure and monitor key metrics related to work performance
  • Foster a positive work environment for colleagues
  • Special projects as needed

Additional Responsibilities:

  • Backfill Eligibility Department by calling insurance companies to verify Benefits and Eligibility information for ABA Therapy, Speech, OT and PT
  • Research specific payor billing rules as needed
  • Update Eligibility Request Spreadsheet
  • Stay informed about Payor and Industry Billing rules
  • Review & interpret payor contracts when applicable
  • Cross collaboration with Billing Services team, as needed

Requirements:

  • HS Diploma or Equivalent
  • Willing to learn
  • Positive attitude and loves a good challenge
  • Professional phone skills
  • This role requires exceptional attention to detail, critical thinking and excellent communication with internal teams and insurance companies

Preferred Qualifications:

  • Previous ABA Prior-Authorization experience. Speech, OT and Mental Health would be a plus
  • Minimum 1-year experience working remotely
  • Minimum 1 year experience in Prior-Authorizations both major commercial insurance companies as well as state Medicaid programs
  • Experience using Billing Software (Azalea, Kareo), EMR and Clearinghouse systems (Waystar, Trizetto)
  • Experience using insurance company websites/portals
  • Proficient using Microsoft Suite (Outlook, Excel, Word) and Google Docs/Sheets

Education:

  • HS Diploma or Equivalent required

Benefits:

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  • PTO and Vacation Days after a 90-day introductory period
  • Paid Holidays
  • Generous Health, Denial & Vision benefits package
  • 401k + Matching

Job Type: Full-time, Monday-Friday (9-6 PM), Hourly

Our commitment to an inclusive workplace

RethinkFirst is an equal opportunity employer and is committed to providing a workplace free from harassment and discrimination. We celebrate the unique differences of our employees because that is what drives curiosity, innovation, and the success of our business. We do not discriminate on the basis of race, religion, color, national origin, gender, sexual orientation, gender identity or expression, age, marital status, veteran status, disability status, pregnancy, parental status, genetic information, political affiliation, or any other status protected by the laws or regulations in the locations where we operate. Accommodations are available for applicants with disabilities.

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