Recovery Innovations
Lead Authorization Specialist
Recovery Innovations, Fife, Washington, United States,
Recovery Innovations is the leader in Peer-Powered Support to those in crisis for mental health and substance use.
Our
Mission
is to empower people to recover, succeed in accomplishing their goals, find meaning and purpose in life, and reconnect with themselves and others.
Our
Vision
is to activate the next generation of frame-breaking healthcare innovation to support people beyond their behavioral health needs and succeed in the community where they live, work, and play.
Job Type
Full-Time: Non-Exempt
Shift
Day
Shift Hours
Monday - Friday - 8:00am - 5:00pm
Work Setting
Remote
Salary/Hourly Wage
$25.48 - $33.65 / hour
Our Position
The Lead Authorization Specialist position functions as the designated state expert responsible for reviewing clinical documentation per HCPCS, CPT, and ICD-10 codes, initiating, submitting, and follow up on authorizations per payer portals, and by faxing requests. They complete data entry and administrative support functions for the organization’s front-end operations.
Your Rewards
Nine (9) company-paid Holidays
(Full-Time Only)
Paid-Time Off ; Accrued bi-weekly (Full-Time Only)
Company-Paid group life insurance
(Full-Time Only)
Medical, Dental, and Vision
plans start the 1st of the month following your start date (Full-Time Only)
Retirement Plans
with Company match including 401k and Roth
Employee Assistance Programs
(Full-Time Only)
Your Responsibilities
Assist in training new Authorization Specialists and develop quality assurance processes.
Verify insurance coverage and eligibility.
Knowledge of CPT, HCPCS, and ICD-10 codes.
Review documentation to determine necessity of prior authorization.
Run account detail reports for proper follow up.
Provide feedback on project status to departments and payers.
Communicate effectively with providers, team members and clients.
Document authorization numbers and processes.
Maintain accurate patient medical records.
Make calls to insurance companies for authorization status.
Analyze and report on payer issues to the Revenue Cycle Manager.
Research authorization denial reasons to maximize claim reimbursement.
Follow submission processes for corrected authorizations and appeals.
Maintain tracking sheets of pending/resolved issues.
Adhere to compliance standards and stay updated on regulations.
Perform other related duties as assigned.
Travel as needed.
Our Requirements
Organized and detail-oriented.
Excellent time management skills.
High school diploma or equivalent.
5+ years of authorization experience required.
Minimum of 1 year of management or supervisory experience required.
Advanced knowledge of CMS guidelines and coding policies.
Reliable and able to multi-task in a fast-paced environment.
Intermediate to Advanced proficiency in Microsoft Excel.
Must have a valid driver license and be 18 years of age.
Ability to maintain confidentiality (HIPAA guidelines).
We are a Second-Chance Employer: Must pass a seven-year background check, substance abuse testing, education verification, and motor vehicle report check.
Recovery Innovations
is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to any characteristic protected by applicable laws. If you need assistance due to a disability during the application process, please send a request via the Accommodation request form.
Benefits/perks may vary depending on the nature of your employment with Recovery Innovations.
The wage range for this role considers various factors including skill sets, experience, and organizational needs. Compensation decisions are dependent on the facts and circumstances of each case.
#J-18808-Ljbffr
Our
Mission
is to empower people to recover, succeed in accomplishing their goals, find meaning and purpose in life, and reconnect with themselves and others.
Our
Vision
is to activate the next generation of frame-breaking healthcare innovation to support people beyond their behavioral health needs and succeed in the community where they live, work, and play.
Job Type
Full-Time: Non-Exempt
Shift
Day
Shift Hours
Monday - Friday - 8:00am - 5:00pm
Work Setting
Remote
Salary/Hourly Wage
$25.48 - $33.65 / hour
Our Position
The Lead Authorization Specialist position functions as the designated state expert responsible for reviewing clinical documentation per HCPCS, CPT, and ICD-10 codes, initiating, submitting, and follow up on authorizations per payer portals, and by faxing requests. They complete data entry and administrative support functions for the organization’s front-end operations.
Your Rewards
Nine (9) company-paid Holidays
(Full-Time Only)
Paid-Time Off ; Accrued bi-weekly (Full-Time Only)
Company-Paid group life insurance
(Full-Time Only)
Medical, Dental, and Vision
plans start the 1st of the month following your start date (Full-Time Only)
Retirement Plans
with Company match including 401k and Roth
Employee Assistance Programs
(Full-Time Only)
Your Responsibilities
Assist in training new Authorization Specialists and develop quality assurance processes.
Verify insurance coverage and eligibility.
Knowledge of CPT, HCPCS, and ICD-10 codes.
Review documentation to determine necessity of prior authorization.
Run account detail reports for proper follow up.
Provide feedback on project status to departments and payers.
Communicate effectively with providers, team members and clients.
Document authorization numbers and processes.
Maintain accurate patient medical records.
Make calls to insurance companies for authorization status.
Analyze and report on payer issues to the Revenue Cycle Manager.
Research authorization denial reasons to maximize claim reimbursement.
Follow submission processes for corrected authorizations and appeals.
Maintain tracking sheets of pending/resolved issues.
Adhere to compliance standards and stay updated on regulations.
Perform other related duties as assigned.
Travel as needed.
Our Requirements
Organized and detail-oriented.
Excellent time management skills.
High school diploma or equivalent.
5+ years of authorization experience required.
Minimum of 1 year of management or supervisory experience required.
Advanced knowledge of CMS guidelines and coding policies.
Reliable and able to multi-task in a fast-paced environment.
Intermediate to Advanced proficiency in Microsoft Excel.
Must have a valid driver license and be 18 years of age.
Ability to maintain confidentiality (HIPAA guidelines).
We are a Second-Chance Employer: Must pass a seven-year background check, substance abuse testing, education verification, and motor vehicle report check.
Recovery Innovations
is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to any characteristic protected by applicable laws. If you need assistance due to a disability during the application process, please send a request via the Accommodation request form.
Benefits/perks may vary depending on the nature of your employment with Recovery Innovations.
The wage range for this role considers various factors including skill sets, experience, and organizational needs. Compensation decisions are dependent on the facts and circumstances of each case.
#J-18808-Ljbffr