Reauthorization Specialist - Infusion

Description

Promptcare is seeking a highly motivated and detail-oriented Reauthorization Specialist to join our team. The Reauthorization Specialist will be responsible for obtaining and maintaining insurance authorizations for infusion therapy services. The ideal candidate will have experience in healthcare insurance and be able to work in a fast-paced environment. If you are a self-starter with a passion for healthcare and a desire to make a difference in patients' lives, we encourage you to apply for this exciting opportunity. To learn more about our company, visit us at PromptCare In-home Respiratory and Infusion

Reporting to: Departmental Lead, Supervisor or Manager

Job Type:   Full time, 40 hours per week, Monday - Friday
Location:   Hybrid in New Providence, NJ
 

Requirements

• High School Diploma or equivalent
• Experience in medical office, patient contact and related experience required
• Microsoft Office Suite experience required
• Excellent oral and written communication skills are required to communicate with colleagues, management, patients, and physician offices
• Medical Reimbursement background is preferred
• CPR+ software or Caretend experience is desirable 

Job Responsibilities, included but not limited to:

• Initiate new and concurrent authorization requests to insurance payers for Home Infusion Therapy
• Completes follow-up on pending and or expired authorizations
• Review authorization approvals and denials for accuracy and initiate appeal process until the case is overturned, appeal options are exhausted, or a decision is made to discontinue the process
• Documents details of all calls, faxed, and email communications in CPR+ software or Caretend per SOP of the department
• Maintains documented record of approved/denied authorizations in the patients’ chart for reference
• Maintains strict confidentiality and adhere to HIPPA guidelines and regulations
• Maintains a broad range of knowledge of insurance plan requirements, medical terminology, government regulation, and codes
• Timely follow-up and response for all quality reviews
• Work as a team player and shares knowledge gained per insurance updates ad communications with management and team members
• Escalate problem accounts and ensure resolution 
• Regular contact with patients, insurance plans, physician offices and other personnel is necessary
• Other duties as assigned by Intake Manager

Physical Demands 

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. While performing the duties of this job, the employee is regularly required to talk and listen. Requires the ability to lift files, open filing cabinets and bend or stand as necessary. This position requires the ability to occasionally lift office products and supplies of 20 pounds but no more than 35 pounds.

Benefits & Perks 

• Competitive Salary
• Medical, Dental, Vision Package 
• 401(k) plan (discretionary)
• PTO - Vacation, Sick and Personal days, and paid holidays
• Referral bonuses & Discount Ticket Program 
• Employee Recognition Program

Equal Employment Opportunity 

The PromptCare Companies is committed to Equal Employment Opportunity (EEO) and prohibits employment discrimination on the basis of race, color, age, national origin, religion, gender, gender identity, sexual orientation, pregnancy, marital status, genetic disposition, disability, veteran's status or any other characteristic or classification protected by State/Federal/Local laws. We foster a work environment in which diversity and inclusion are embraced, people are hired and advanced on their merits, and employees are treated with mutual respect and dignity.