Prior Authorization Representative

We will be hiring for Prior Authorization/Insurance Verification Representatives working remote at our Healthcare client! These are remote US roles. Must have reliable internet, dedicated workspace and be able to work 12pm-9pm EST hours, M-F. Hours: M-F, 12PM-9PM EST Pay Rate: $18/hr Start Date: 6/22 100% Remote US - equipment is provided This is a contract role - project based with possibility for extension or permanent placement. Must have previous Medical Billing, Prior Authorization, or Insurance Verification experience handled obtaining, verifying, and coordination of benefits. Job Duties:

• Obtain and verify insurance eligibility for services provided and document complete information in system
• Perform prior authorizations as required by payor source, including procurement of needed documentation by collaborating with physician offices and insurance companies
• Collect any clinical information such as lab values, diagnosis codes, etc.
• Determine patient’s financial responsibilities as stated by insurance
• Configure coordination of benefits information on every referral
• Ensure assignment of benefits are obtained and on file for Medicare claims
• Bill insurance companies for therapies provided
• Document all pertinent communication with patient, physician, insurance company as it may relate to collection procedures
• Identify and coordinate patient resources as it pertains to reimbursement, such as copay cards, third party assistance programs, and manufacturer assistance programs
• Handle inbound calls from patients, physician offices, and/or insurance companies
• Resolve claim rejections for eligibility, coverage, and other issues

Please send your email to [email protected] for next steps! salary: $17.99 - $18 per hour shift: First work hours: 12 PM - 9 PM education: High School

Responsibilities

• Obtain and verify insurance eligibility for services provided and document complete information in system
• Perform prior authorizations as required by payor source, including procurement of needed documentation by collaborating with physician offices and insurance companies
• Collect any clinical information such as lab values, diagnosis codes, etc.
• Determine patient’s financial responsibilities as stated by insurance
• Configure coordination of benefits information on every referral
• Ensure assignment of benefits are obtained and on file for Medicare claims
• Bill insurance companies for therapies provided
• Document all pertinent communication with patient, physician, insurance company as it may relate to collection procedures
• Identify and coordinate patient resources as it pertains to reimbursement, such as copay cards, third party assistance programs, and manufacturer assistance programs
• Handle inbound calls from patients, physician offices, and/or insurance companies
• Resolve claim rejections for eligibility, coverage, and other issues

Skills

• Insurance Verification (1 year of experience is required)
• Prior Authorization (1 year of experience is required)
• Customer Service (1 year of experience is required)
• computer skills

Qualifications

• Years of experience: 1 year
• Experience level: Entry Level

Randstad is a world leader in matching great people with great companies. Our experienced agents will listen carefully to your employment needs and then work diligently to match your skills and qualifications to the right job and company. Whether you're looking for temporary, temporary-to-permanent or permanent opportunities, no one works harder for you than Randstad. Equal Opportunity Employer: Race, Color, Religion, Sex, Sexual Orientation, Gender Identity, National Origin, Age, Genetic Information, Disability, Protected Veteran Status, or any other legally protected group status. At Randstad, we welcome people of all abilities and want to ensure that our hiring and interview process meets the needs of all applicants. If you require a reasonable accommodation to make your application or interview experience a great one, please contact [email protected]. Pay offered to a successful candidate will be based on several factors including the candidate's education, work experience, work location, specific job duties, certifications, etc. In addition, Randstad offers a comprehensive benefits package, including: medical, prescription, dental, vision, AD&D, and life insurance offerings, short-term disability, and a 401K plan (all benefits are based on eligibility). This posting is open for thirty (30) days. It is unlawful in Massachusetts to require or administer a lie detector test as a condition of employment or continued employment. An employer who violates this law shall be subject to criminal penalties and civil liability. Apply tot his job Apply To this Job