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Prior authorization specialist work from home jobs - 568 jobs

  • Maternity Care Authorization Specialist (Hybrid Potential)

    Christian Healthcare Ministries 4.1company rating

    Remote job

    This role plays a key part in ensuring maternity care bills are processed accurately and members receive timely support during an important season of life. The specialist serves as a detail-oriented professional who upholds CHM's commitment to excellence, compassion, and integrity. WHAT WE OFFER Compensation based on experience. Faith and purpose-based career opportunity! Fully paid health benefits Retirement and Life Insurance 12 paid holidays PLUS birthday Lunch is provided DAILY. Professional Development Paid Training ESSENTIAL JOB FUNCTIONS Compile, verify, and organize information according to priorities to prepare data for entry Check for duplicate records before processing Accurately enter medical billing information into the company's software system Research and correct documents submitted with incomplete or inaccurate details Verify member information such as enrollment date, participation level, coverage status, and date of service before processing medical bills Review data for accuracy and completeness Uphold the values and culture of the organization Follow company policies, procedures, and guidelines Verify eligibility in accordance with established policies and definitions Identify and escalate concerns to leadership as appropriate Maintain daily productivity standards Demonstrate eagerness and initiative to learn and take on a variety of tasks Support the overall mission and culture of the organization Perform other duties as assigned by management SKILLS & COMPETENCIES Core strengths like problem-solving, attention to detail, adaptability, collaboration, and time management. Soft skills such as empathy (especially important in maternity care), professionalism, and being able to handle sensitive information with care. EXPERIENCE REQUIREMENTS Required: High school diploma or passage of a high school equivalency exam Medical background preferred but not required. Capacity to maintain confidentiality. Ability to recognize, research and maintain accuracy. Excellent communication skills both written and verbal. Able to operate a PC, including working with information systems/applications. Previous experience with Microsoft Office programs (I.e., Outlook, Word, Excel & Access) Experience operating routine office equipment (i.e., faxes, copy machines, printers, multi-line telephones, etc.) About Christian Healthcare Ministries Founded in 1981, Christian Healthcare Ministries (CHM) is a health care sharing ministry for Christians. CHM is a nonprofit, voluntary cost-sharing ministry through which participating Christians meet each other's medical bills. The mission of CHM is to glorify God, show Christian love, and experience God's presence as Christians share each other's medical bills.
    $31k-35k yearly est. 4d ago
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  • Patient Scheduling Specialist

    Medasource 4.2company rating

    Remote job

    Medical Support Assistant Duration: 1 year contract (strong possibility of extension!) Onsite: Denver, CO Full Time: M-F, Day Shift Overview: We are seeking reliable and mission-driven Medical Support Assistants to support Veterans served by a large healthcare system. MSAs provide critical front-line administration support across outpatient clinics and virtual care services. Responsibilities: • Customer service, appointment scheduling, and records management • Answer phones, greet Veteran patients, schedule appointments and consults • Help determine a clinic's daily needs, and verify and update insurance information Required Qualifications: • Minimum 6+ months of customer service experience • 1+ year of clerical, call center, or healthcare administrative experience • High school diploma or GED required • Proficient with medical terminology • Typing speed of 50 words per minute or more • Ability to pass a federal background check • Reliable internet for a remote work environment
    $35k-42k yearly est. 1d ago
  • Insurance Billing Specialist - Medicare & Medicaid Denial And Appeals

    Teksystems 4.4company rating

    Remote job

    TEKsystems has a current opening for a remote insurance follow up/medical billing candidate. Qualified individuals will have a minimum of 2 years of experience with Iowa and/or Illinois Medicaid and Medicare insurance follow up experience. *Description* Daily Duties: * Work with centralized cash posting team to resolve missing or unposted remite * Ensure all claims are accurately transmitted daily and all appropriate documentation is sent when required * Verify eligibility and claims status on unpaid claims * Provide timely feedback to management of identified claims issues, repetitive errors, and payer trends to expedite claims adjudication * Work accounts in assigned queues in accordance with departmental guidelines * Work directly with third party payers and internal/external customers toward effective claims resolution. *Skills & Qualifications* High School graduate or equivalent Must have Iowa and/or Illinois Medicaid payer experience Physician Billing and Denial/Follow Up experience - 2+ years EPIC experience Payer portal claim corrections and reconsiderations knowledge - ex. Availity Work from home space required *Job Type & Location*This is a Contract position based out of West Des Moines, IA. *Pay and Benefits*The pay range for this position is $19.00 - $22.00/hr. Eligibility requirements apply to some benefits and may depend on your job classification and length of employment. Benefits are subject to change and may be subject to specific elections, plan, or program terms. If eligible, the benefits available for this temporary role may include the following: * Medical, dental & vision * Critical Illness, Accident, and Hospital * 401(k) Retirement Plan - Pre-tax and Roth post-tax contributions available * Life Insurance (Voluntary Life & AD&D for the employee and dependents) * Short and long-term disability * Health Spending Account (HSA) * Transportation benefits * Employee Assistance Program * Time Off/Leave (PTO, Vacation or Sick Leave) *Workplace Type*This is a fully remote position. *Application Deadline*This position is anticipated to close on Jan 23, 2026. h4>About TEKsystems: We're partners in transformation. We help clients activate ideas and solutions to take advantage of a new world of opportunity. We are a team of 80,000 strong, working with over 6,000 clients, including 80% of the Fortune 500, across North America, Europe and Asia. As an industry leader in Full-Stack Technology Services, Talent Services, and real-world application, we work with progressive leaders to drive change. That's the power of true partnership. TEKsystems is an Allegis Group company. The company is an equal opportunity employer and will consider all applications without regards to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law. About TEKsystems and TEKsystems Global Services We're a leading provider of business and technology services. We accelerate business transformation for our customers. Our expertise in strategy, design, execution and operations unlocks business value through a range of solutions. We're a team of 80,000 strong, working with over 6,000 customers, including 80% of the Fortune 500 across North America, Europe and Asia, who partner with us for our scale, full-stack capabilities and speed. We're strategic thinkers, hands-on collaborators, helping customers capitalize on change and master the momentum of technology. We're building tomorrow by delivering business outcomes and making positive impacts in our global communities. TEKsystems and TEKsystems Global Services are Allegis Group companies. Learn more at TEKsystems.com. The company is an equal opportunity employer and will consider all applications without regard to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.
    $19-22 hourly 2d ago
  • Patient Access Representative

    Insight Global

    Remote job

    One of our top clients is looking for a team of Patient Access Representatives within a call center environment in Beverly Hills, CA! This person will be responsible for handling about 50+ calls per day for multiple specialty offices across Southern California. This position is fully on-site for 2 - 4 months, then fully remote. Required Skills & Experience HS Diploma 2+ years healthcare call center experience (with an average call time of 5 minutes or less on calls) Proficient with scheduling appointments through an EHR software 2+ years experience scheduling patient appointments for multiple physicians in one practice 40+ WPM typing speed Experience handling multiple phone lines Nice to Have Skills & Experience Proficient in EPIC Experience verifying insurances Basic experience with Excel and standard workbooks Experience in either pain management, dermatology, Neurology, Endocrinology, Rheumatology, or Nephrology. Responsibilities Include: Answering phones, triaging patients, providing directions/parking instructions, contacting clinic facility to notify if a patient is running late, scheduling and rescheduling patients' appointments, verifying insurances, and assisting with referrals/follow up care. This position is on-site until fully trained and passing multiple assessments (typically around 2-4 months of working on-site - depending on performance) where it will then go remote.
    $33k-42k yearly est. 2d ago
  • Remote Prior Authorization Pharmacist

    Pharmacy Careers 4.3company rating

    Remote job

    Remote Prior Authorization Pharmacist - Work From Home in Managed Care A confidential managed care organization is seeking a motivated Remote Prior Authorization Pharmacist to evaluate prescription requests, ensure medical necessity, and improve patient access to safe and effective therapies. This work-from-home position is ideal for pharmacists who want to transition out of retail or hospital settings while building expertise in managed care. Key Responsibilities Review prior authorization requests for accuracy, appropriateness, and clinical necessity. Apply plan criteria, evidence-based guidelines, and regulatory standards to determinations. Communicate approval/denial decisions clearly to providers and patients. Collaborate with physicians, nurses, and medical directors on complex cases. Document outcomes in compliance with health plan policies and CMS/state regulations. Support process improvements to streamline workflow and turnaround times. What You'll Bring Education: Doctor of Pharmacy (PharmD) or Bachelor of Pharmacy degree. Licensure: Active and unrestricted pharmacist license in the U.S. Experience: Prior authorization, utilization management, or managed care preferred - retail or hospital pharmacists with strong clinical judgment are encouraged to apply. Skills: Excellent clinical review, documentation, and communication skills. Why This Role? Flexibility: 100% remote work from home with flexible scheduling options. Impact: Directly influence patient access to safe and cost-effective medications. Growth: Build specialized skills in utilization management and managed care. Rewards: Competitive compensation, benefits, and career advancement opportunities. About Us We are a confidential healthcare partner working with health plans and PBMs across the U.S.. Our pharmacists ensure patients receive the right therapy at the right time while maintaining compliance with all regulations. Apply Today Take the next step in your career with our Remote Prior Authorization Pharmacist opportunity - and enjoy the benefits of working from home while shaping the future of managed care.
    $25k-34k yearly est. 60d+ ago
  • Prior Authorization Coordinator

    IVX Health

    Remote job

    Join IVX Health as a Prior Authorization Coordinator! Join a team that's redefining infusion care and creating exceptional patient experiences. Are you experienced in navigating the complexities of prior authorizations for biologics or oncology therapies? IVX Health is looking for a driven and detail-oriented Prior Authorization Coordinator to support our rapidly growing team. In this role, you'll have the opportunity to make a meaningful impact by facilitating the approval process for life-changing specialty treatments. Our HQ is based just outside of Nashville in Brentwood, TN, but we are seeking candidates nationwide with the option to work fully remote, hybrid, or in-office! Location and Schedule at a Glance Work Options: Fully Remote, Hybrid, or In-office (Brentwood, TN) Schedule: Monday - Friday, standard business hours (no nights, weekends, or holidays) What You Will Do Review and Process Prior Authorizations - Thoroughly review Prior Authorization orders and ensure timely and accurate completion. Manage Clinical Documentation - Obtain and assess necessary clinical information such as medical history, diagnosis, and lab reports to support Prior Authorization submissions. Submit and Track Prior Authorizations - Follow criteria for medication approvals and accurately submit requests to insurance providers. Resolve Authorization Issues - Investigate and resolve outstanding medical documentation concerns and assist in resolving denied claims. Support Patients and Providers - Communicate effectively with patients, clinical staff, and insurance representatives regarding the Prior Authorization process. Ensure Compliance and Process Improvement - Stay up to date with evolving payer policies and identify ways to enhance workflow efficiency. Perform Additional Duties - Take on other responsibilities as assigned to support patient care and operational objectives. What We Are Looking For We are seeking ambitious, self-motivated, and reliable professionals who take ownership of their work and excel in both remote and office settings. Success in this role requires initiative, accountability, and a commitment to getting the job done. If you thrive in a structured yet independent work environment, communicate effectively, and hold yourself accountable, you will excel here. We value high performers who are dependable, communicative, and committed to delivering results. Prior Authorization Expertise is Essential - You must have hands-on experience with prior authorizations for biologics, oncology, or specialty therapies, along with a strong understanding of payer guidelines. Exceptional Communication Skills - This role involves frequent interaction with clinical teams, insurance companies, and patients. You must be able to communicate clearly, professionally, and persistently follow up when needed. Self-Motivated and Accountable - If you work remotely, you are expected to be present, engaged, and consistently perform at a high level without direct supervision. Tech-Savvy and Detail-Oriented - Proficiency in Electronic Health Records (EHR) systems, payer portals, and Microsoft Office Suite is required. High School Diploma or GED required. Associate's degree in Medical Office Management, Medical Insurance, or Medical Coding is a plus. Minimum of three (3) years of experience in hospital or clinical service access, physician office scheduling, or a similar role. Certified Medical Assistant (CMA) is a plus. Experience with prior authorizations for biologics, oncology, or specialty therapies preferred. Why Join IVX Health Make a Meaningful Impact - Play a critical role in securing approvals for life-changing specialty treatments that directly improve patients' lives. Grow Your Career - IVX Health offers a clear career path for Prior Authorization Coordinators, with opportunities for promotion from Level 1 to Level 2 and Level 3 based on performance and expertise.. Be Part of a Supportive and High-Performing Team - Work alongside a motivated, goal-driven team that values accountability, integrity, and results while fostering a positive, patient-focused environment. Support and Development - Gain access to continuing education, professional development resources, and mentorship opportunities to expand your expertise. Work-Life Balance - Enjoy flexible work options (remote, hybrid, or in-office), paid time off, and a no nights, no weekends schedule so you can recharge and perform at your best. Pay is based on factors such as market location, job-related knowledge, skills, and experience, and is benchmarked against similar organizations in our size and industry. It is not typical for an individual to be hired at or near the top of the posted range, as compensation decisions depend on the facts and circumstances of each case. In addition to cash pay, full-time regular employees are eligible for 401(k), health benefits, and other company-provided benefits; some of these benefits may also be available to part-time employees. Prior Authorization Coordinator Pay Range$20-$24 USD About IVX Health IVX Health is a national provider of infusion and injection therapy for individuals managing chronic conditions like Rheumatoid Arthritis, Crohn's Disease, and Multiple Sclerosis. We're transforming the way care is delivered with a focus on patient comfort and convenience. Our commitment to exceptional care extends to our employees as well-we empower our team to thrive while living our core values: Be Kind, Do What's Right, Never Settle, Make It Happen, and Enjoy the Ride. Our Mission: To improve the lives of those we care for by redefining the care experience Our Vision: To be the nation's preferred destination for pharmaceutical care of complex chronic conditions Our Commitment: To deliver an unmatched care experience with a foundation in world class service and clinical excellence Benefits We Offer Comprehensive Healthcare - Medical, dental, and vision coverage, including prescription drug plans and telemedicine services. Flexible Savings Options - Choose from Health Savings Accounts (HSA) and Health Reimbursement Arrangements (HRA) to manage healthcare costs. Supplemental Protection - Accident, critical illness, and hospital indemnity plans to provide additional financial security. Dependent Care FSA - Pre-tax savings for eligible childcare and dependent care expenses. 401(k) Retirement Plan - Secure your future with a competitive company match. Disability Coverage - Voluntary short-term and long-term disability plans to protect your income. Fertility and Family Support - Resources and benefits designed to support fertility care and family planning. Life and AD&D Insurance - Financial protection for you and your loved ones. Counseling and Wellness Support - Free resources to support emotional, physical, and financial well-being. Education Assistance - Tuition reimbursement and certification support to help you grow in your career. Continuing Education - Access to a CEU library for ongoing professional development. Charitable Giving and Volunteer Program - Matched donations and paid volunteer time off to support causes you care about. Employee Referral Bonus - Earn rewards for helping us find top talent. Note: Benefits may vary by employment type. Contact HR for details on eligibility and coverage. EEO STATEMENT IVX Health is proud to be an Equal Opportunity Employer. We value diversity and are committed to creating an inclusive environment for all employees. IVX Health wants to have the best available people in every job, and we make employment decisions on the basis of business needs, job requirements, individual qualifications, and merit. Equal employment opportunities are provided to all employees and applicants for employment without regard to race, color, religion, sex, sexual orientation, gender identity, pregnancy, national origin, military and veteran status, age, physical or mental disability, genetic characteristic, reproductive health decisions, family or parental status, or any other legally protected category in accordance with applicable federal, state, or local laws. IVX Health prohibits discrimination, harassment, or retaliation of any kind based on any of these characteristics. Equal employment opportunity will be extended to all persons in all aspects of the employer-employee relationship and all terms and conditions of employment, including, but not limited to, hiring, training, promotion, discipline, compensation benefits, and separation of employment. Privacy Policy
    $20-24 hourly Auto-Apply 12h ago
  • Prior Authorizations Manager

    Aidin

    Remote job

    Hi, we're Aidin! We're here to create solutions for healthcare's biggest challenges. Instead of waiting for someone else to step up, we rolled up our sleeves and created a better way to connect patients, payers, and care providers. We are on a mission to defragment the healthcare ecosystem with a seamless digital platform that transforms healthcare for good and improves outcomes for all. What we do Aidin is a dynamic healthcare technology company dedicated to revolutionizing care coordination and post-acute care transitions. Our innovative platform empowers healthcare organizations to streamline workflows, reduce costs, and ensure patients receive the highest quality post-acute care. You can learn more about us at **************** About The Opportunity We are seeking a dynamic, strategic leader and subject matter expert in Prior Authorizations to drive operational excellence and innovation at Aidin. This role is responsible for owning and scaling Aidin's Prior Authorizations function-ensuring consistent, high-quality execution while continuously improving processes, systems, and outcomes for clients, staff, and patients. As Prior Authorizations Manager, you will lead day-to-day operations and serve as the escalation point for complex payer, hospital, and provider issues. This is a hands-on role, requiring both ownership of the process and execution of the day to day activities as we grow and enhance this functionality at Aidin. You will partner closely with Client Operations, Product, and other cross-functional teams to shape strategy, influence roadmap decisions, and build a best-in-class authorization capability that supports Aidin's growth and mission: ensuring patients transition, on-time, to the best provider every time. This role reports to the Senior Director, Client Operations. Key Responsibilities Operational Ownership Oversee daily Prior Authorizations operations, ensuring queues are managed efficiently and authorizations are submitted accurately and on time Define and monitor key performance metrics; use data to identify trends, risks, and improvement opportunities Own payer onboarding and eligibility demarcation strategies across hospitals and markets Serve as the primary point of accountability for issue resolution with payers, including portal-based workflows such as Availity Provide real-time guidance and escalation support for complex authorization challenges Establish training, onboarding, and ongoing education programs to ensure team readiness as Aidin scales Process Improvement Design, document, and continuously refine standard operating procedures that scale with the business Identify opportunities to improve authorization workflows through automation, tooling, and process redesign Partner with Product to identify, quantify, and prioritize feature enhancements that meaningfully advance the Prior Authorizations business Contribute to broader Client Operations strategy, ensuring alignment with Aidin's growth objectives Cross-Functional Collaboration Work closely with Client Operations leadership, Product, and Customer-facing teams to ensure alignment and clarity Translate payer and operational complexity into actionable insights for internal stakeholders Represent the Prior Authorizations function as Aidin expands into new markets and payer relationships What You'll Bring 5+ years of direct experience in Prior Authorizations, including extensive payer portal and direct payer engagement across the U.S. Demonstrated experience leading or mentoring others, with a track record of driving operational results Deep understanding of payer workflows, eligibility requirements, and authorization best practices Strong problem-solving skills and comfort navigating ambiguity and complex edge cases A growth mindset, with ambition to build, scale, and improve systems and teams Excellent communication skills and the ability to influence across functions Adaptability and resilience in a fast-moving environment Startup, B2B SaaS, Healthcare IT, or health-tech experience strongly preferred What Success Looks Like A successful Prior Authorizations Manager: Brings confident leadership, operational rigor, and strategic thinking to the Prior Authorizations function Owns performance outcomes, including turnaround times, payer responsiveness, accuracy, and client satisfaction Builds scalable processes, documentation, and best practices that enable consistent execution across markets and payers Acts as a trusted internal expert and partner, translating operational realities into product and process improvements Culture and Values: At Aidin, our team is guided by four core values that shape everything we do: Lead, Do Not React: Think big-picture, long-term, and do the right thing. We want team members who take initiative and lead with vision, rather than simply reacting to circumstances Make a Difference: For us, outcomes are everything. Be the solution. We value making a tangible impact through every event and initiative Embrace Uniqueness: Boldly be who we are. Individuality and authenticity are strengths that we bring to our work Celebrate the Doer: We celebrate action and the people who make it happen. If you thrive on taking initiative and seeing real results, you'll fit right in Why Work at Aidin? Be a part of a trailblazing, mission driven organization that is revolutionizing patient care transitions Opportunity to work and grow with talented, mission-driven, passionate professionals Flexible remote work environment Generous PTO Policy, plus 12 national holidays Several Team Offsites each year where we come together and align on our vision, mission, values, and strategic initiatives Comprehensive benefits package Commitment to Diversity At Aidin, we strive to create a mindful and respectful environment where everyone can bring their authentic self to work, and experience a culture that is free of harassment, racism, and discrimination. That's why we are committed to diversity and inclusion in the workplace, and we prohibit discrimination and harassment of any kind based on race, color, religion, sex, sexual orientation, gender identity, national origin, age, disability, protected veteran status or any other characteristic protected by law. This policy applies to all employment practices within our organization, including, but not limited to, hiring, recruiting, promotion, termination, layoff, and leave of absence.
    $31k-41k yearly est. 11d ago
  • Prior Authorization Quality Assurance Pharmacist

    Capital Rx 4.1company rating

    Remote job

    About Judi Health Judi Health is an enterprise health technology company providing a comprehensive suite of solutions for employers and health plans, including: Capital Rx, a public benefit corporation delivering full-service pharmacy benefit management (PBM) solutions to self-insured employers, Judi Health™, which offers full-service health benefit management solutions to employers, TPAs, and health plans, and Judi , the industry's leading proprietary Enterprise Health Platform (EHP), which consolidates all claim administration-related workflows in one scalable, secure platform. Together with our clients, we're rebuilding trust in healthcare in the U.S. and deploying the infrastructure we need for the care we deserve. To learn more, visit **************** Position Summary: The QA Pharmacist will use their state regulatory knowledge to perform routine auditing and monitoring processes to ensure quality, accuracy, and regulatory compliance of coverage requests and appeals. The QA Pharmacist will utilize a strong comprehension of regulatory requirements to ensure success in annual reporting, program audits, and ad hoc audits. Position Responsibilities: Complete monthly utilization management and appeals performance and process audits in alignment with applicable regulations, accreditation standards, and best practices. Create and maintain progress reports and audit results in accordance with regulatory/accreditation requirements and internal processes. Present audit results to leadership in a timely manner to address issues and ensure adherence to departmental procedures and regulatory/accreditation requirements (CMS, URAC, NCQA). Continuously review and remain informed of all regulatory/accreditation requirements and updates impacting the coverage request and appeals processes. Respond to inquiries from internal and external stakeholders regarding quality assurance processes, audit results, and compliance policies and procedures. Work independently and with team members as warranted by audit assignment. Assist in designing and implementing audit tools and programs, creating QA scorecards and guides in collaboration with all department stakeholders. Provide ongoing performance feedback, to team leads to ensure consistent performance. Assist management in identifying, evaluating, and mitigating operational, and compliance risks. Work in collaboration with operational leaders to identify training opportunities and recommend improvements to Work Instructions, Job Aids, and Policy and Procedures to improve performance. Minimum Qualifications: Active, unrestricted, pharmacist license required 2+ years of state regulatory and audit utilization management experience at a PBM or health plan required Extensive knowledge of how to operationalize regulatory requirements Strong oral and written communication skills required Intermediate to advanced Microsoft Excel skills required Possess strong analytical skills, attention to detail, quantitative, and problem-solving abilities Ability to work independently with minimal supervision, stay productive in a remote, high-volume, metric driven work environment Ability to multi-task and collaborate in a team with shifting priorities Preferred Qualifications: Familiarity/experience with URAC and NCQA accreditation requirements Utilization management and/or appeals audit experience 3+ years of compliance or regulatory experience at a PBM or health plan This position description is designed to be flexible, allowing management the opportunity to assign or reassign duties and responsibilities as needed to best meet organizational goals. #LI-BC1 Salary Range$135,000-$145,000 USD All employees are responsible for adherence to the Capital Rx Code of Conduct including the reporting of non-compliance. This position description is designed to be flexible, allowing management the opportunity to assign or reassign duties and responsibilities as needed to best meet organizational goals. Judi Health values a diverse workplace and celebrates the diversity that each employee brings to the table. We are proud to provide equal employment opportunities to all employees and applicants for employment and prohibit discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, medical condition, genetic information, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws. By submitting an application, you agree to the retention of your personal data for consideration for a future position at Judi Health. More details about Judi Health's privacy practices can be found at *********************************************
    $27k-39k yearly est. Auto-Apply 4d ago
  • Prior Authorization Specialist / Remote

    Brightspring Health Services

    Remote job

    Job Description This role will be responsible for activities relating to the proper initiation, clinical review, submission, and follow up of prior authorizations. This role requires working knowledge of pharmacy benefits and prior authorization process. Schedule: Monday - Friday 9:30am - 6:30pm CST We Offer: • Competitive Pay • Health, Dental, Vision & Life Insurance • Company-Paid Short & Long-Term Disability • Flexible Schedules & Paid Time Off • Tuition Reimbursement • Employee Discount Program & DailyPay • 401k • Pet Insurance Responsibilities Initiate, process, and oversee the clinical review of prior authorization requests for medication and supply, ensuring compliance with payer requirements and clinical guidelines. Collaborate with healthcare providers, insurance companies, and patients to gather necessary clinical information and documentation to support prior authorization submissions. Submit prior authorization requests accurately and in a timely manner, utilizing electronic submission platforms and following established protocols. Knowledgeable to perform all PA functions. Qualifications High School Diploma or GED or licensed/registered pharmacy technician or previous experience in Pharmacy 1+ years pharmacy experience Pharmacy or healthcare-related knowledge Knowledge of pharmacy terminology including sig codes, and Roman numbers, brand/generic names of medication Basic math and analytical skills Intermediate typing/keyboard skills
    $26k-35k yearly est. 4d ago
  • Healthcare Prior Authorizations Specialist - REMOTE

    Quadris Team

    Remote job

    Quadris Team, LLC - A Revenue Cycle Management Group, is searching for that dynamic person to join us, working with our highly skilled Authorizations Team to fill the role of Prior Authorization Specialist for General Surgery. We are a 100% remote team supporting our clients across the United States! See us at ******************** The ideal applicant will reside in Pacific Standard Time or Mountain Standard Time Job Focus: Responsible for obtaining prior authorizations for facility services based on assigned specialty or clinic area. This position will secure the prior authorization and notify the rendering party in the timeliest manner possible so patients can receive necessary care and services with the least delay. Responsible for answering patient calls, providing outgoing patient communication regarding financial obligations and authorization status. Responsible for patient estimation, benefit education, and payment processing. Primary/Essential Expectations For Success: Accurately, efficiently and timely work prior authorization requests-referrals Receive request for prior authorizations through the electronic health record (EHR) and/or via phone, email or fax and ensure that they are properly and closely tracked and monitored Process referrals and submit medical records to insurance carriers to expedite prior authorization processes Manage correspondence with insurance companies, physicians, specialists and patients as needed, including documenting in the EHR as appropriate Assist with medical necessity documentation to expedite approvals and ensure that appropriate follow-up is performed Review accuracy and completeness of information requested and ensure that all supporting documents are present Review denials and follow up with provider to obtain medically necessary information to submit an appeal of the denial Prioritize the incoming authorizations by level of urgency and date of service Secure patient information in accordance with client policy/procedures Other duties as assigned Monitors WQs, and resolves accounts in a timely manner Stay up to date on insurance company policies and procedures related to prior authorizations Physical/Mental Demands, Environment: Prolonged periods of sitting at a desk and working on a computer Must be able to lift 15 pounds at one time Must be able to structure your home office to ensure patient information is secure meeting the regulatory expectations Skills Needed to Be Successful: Maintains compliance with regulations and laws applicable to job Professional level of communication with video, phone, and email Ability to effectively prioritize the work to meet deadlines and expectations Meets the quality and productivity measures as outlined by Quadris Brings positive energy to work Uses critical thinking skills Being present and focused on assigned tasks and eliminates distractions Being a self-starter Ability to work independently and within a team atmosphere Core Talent Essentials: High School diploma or equivalent 1+ years of experience working in health care, medical billing, with a focus on prior authorization preferred PACS (Prior Authorization Certified Specialist) Certification preferred Knowledge of insurance process and medical terminology preferred Honors and sets high expectations for patient confidentiality and customer service in accordance with Quadris Team policies and procedures and HIPAA requirements Advanced level of industry standard electronic medical record content Must have professional level skills in MS products such as Excel, Word, Power Point. Proficient application of business/office standard processes and technical applications
    $28k-38k yearly est. 2d ago
  • Authorization Specialist II #Full Time #Remote

    61St. Street Service Corp

    Remote job

    Top Healthcare Provider Network The 61st Street Service Corporation, provides administrative and clinical support staff for ColumbiaDoctors . This position will support ColumbiaDoctors, one of the largest multi-specialty practices in the Northeast. ColumbiaDoctors practices comprise an experienced group of more than 2,800 physicians, surgeons, dentists, and nurses, offering more than 240 specialties and subspecialties. This position is primarily remote, candidates must reside in the Tri-State area (New York, New Jersey, or Connecticut). Note: There may be occasional requirements to visit the New York or New Jersey office for training, meetings, and other business needs. Opportunity to grow as part of a Revenue Cycle Career Ladder! Job Summary: The Authorization Specialist II is responsible for verifying insurance policy benefit information, and securing payer required authorizations. This position is responsible for obtaining accurate and timely pre-authorizations for professional services prior to the patient s visit, scheduled admission, or immediately following hospital admission. Prior authorizations may include, but are not limited to surgical procedures, outpatient treatments, medications and diagnostic testing (i.e. ultrasounds, labs, radiology, IV therapy, referrals) Job Responsibilities: Verifies insurance coverage via system tools, payer portals (Electronic Query (Real-Time-Eligibility [RTE]/Insurance Payer Portal/Phone). Upon verification of patient's insurance coverage, update changes in the billing system. Confirms provider s participation status with patient s insurance plan/network. Determines payer referral and authorization requirements for professional services. Contacts patient and PCP to secure payer required referral for planned services. Documents referral in practice management system. Researches system notes to obtain missing or corrected insurance or demographic information. Reviews clinical documentation to insure criteria for procedure meets insurance requirements. Initiates authorization and submits clinical documentation as requested by insurance companies. Follows through on pre-certifications until final approval is obtained. Manage faxes, emails, and phone calls in a timely manner. Responds to voicemails and emails within same business day of receipt. Communicates with surgical coordinators regarding authorizations status or denials. Submits appeals in the event of denial of prior authorizations or denial of payment following procedures. Set up peer to peer calls with clinical providers and insurance companies, as needed. Calculate and document patient out of pocket estimates and provide to patient. Assists Supervisor with special projects and/or tasks. Assists Authorization-Referrals Specialist I with complex cases or questions. Serves as back-up to Authorization-Referrals Specialist III. Performs other job duties as assigned. Job Qualifications: Verifies insurance coverage via system tools, payer portals (Electronic Query (Real-Time-Eligibility [RTE]/Insurance Payer Portal/Phone). Upon verification of patient's insurance coverage, update changes in the billing system. Confirms provider s participation status with patient s insurance plan/network. Determines payer authorization requirements for professional services. Researches system notes to obtain missing or corrected insurance or demographic information. Reviews clinical documentation to insure criteria for procedure meets insurance requirements. Initiates authorization and submits clinical documentation as requested by insurance companies. Follows through on pre-certifications until final approval is obtained. Manage faxes, emails, and phone calls. Responds to voicemails and emails. Communicates with surgical coordinators regarding authorizations status or denials. Submits appeals in the event of denial of prior authorizations or denial of payment following procedures. Set up peer to peer calls with clinical providers and insurance companies, as needed. Calculate and document patient out of pocket estimates and provide to patient. Assists Supervisor with special projects and/or tasks. Assists Authorization Specialist I with complex cases or questions. Serves as back-up to Authorization Specialist III. Performs other job duties as assigned. Please note: While this position is primarily remote, candidates must be in a Columbia University approved telework state. There may be occasional requirements to visit the office for meetings or other business needs. Travel and accommodation costs associated with these visits will be the employee's responsibility and not be reimbursed by the company. Job Qualifications: High school graduate or GED certificate is required. A minimum of 1-year experience in a physician s billing or third payer environment. Candidate must demonstrate the ability to understand and navigate managed care eligibility, insurance billing requirements, and obtaining pre-authorizations. Candidate must demonstrate strong customer service and patient focused orientation and the ability to communicate, adapt, and respond to complex situations. Including the ability to diffuse complex situations in a calm and professional manner. Must demonstrate effective communication skills both verbally and written. Ability to multi-task, prioritize, document, and manage time effectively. Functional proficiency in computer software skills (e.g. Microsoft Word, Excel and Outlook, E-mail, etc.) Functional proficiency and comprehension of medical terminology. Experience in Epic and or other electronic billing systems is preferred. Knowledge of medical terminology, diagnosis and procedure coding is preferred. Previous experience in an academic healthcare setting is preferred. Hourly Rate Ranges: $23.69 - $32.00 Note: Our salary offers will fall within these ranges based on a variety of factors, including but not limited to experience, skill set, training and education. 61st Street Service Corporation At 61 st Street Service Corporation we are committed to providing our client with excellent customer service while maintaining a productive environment for all employees. The Service Corporation offers a competitive comprehensive Benefit package to eligible employees; including Healthcare and various other benefits including Paid Time off to promote a healthy lifestyle. We are an equal employment opportunity employer and we adhere to all requirements of all applicable federal, state, and local civil rights laws.
    $23.7-32 hourly 60d+ ago
  • Contact Center Patient Care Representative

    Orthocincy 4.0company rating

    Remote job

    **Join our dynamic team as a frontline patient care representative who interacts with our patients to provide exceptional and compassionate patient care! The patient care representative may have the option to work remotely after an introductory training period. General Job Summary: Vital to the success of our organization with providing OrthoCincy patients and all other callers a premier Ortho experience while focusing on their individual needs. Essential Job Functions: Schedules appointments for patients either by phone when they call in, through the company website or when requested from the clinic via computerized message system. Uses computerized system to match physician/clinician availability with patients' preferences in terms of date and time. Ability to handle a high volume of incoming calls, while maintaining a high standard of productivity, efficiency and accuracy while working under pressure. Must be able to respond to various inquiries made by patients, hospitals, insurance companies, as well as other medical entities. Engaging in active listening with all callers, while acting as a contact point person between patients, providers and staff. Maintains scheduling system so records are accurate and complete and can be used to analyze patient/staffing patterns. Updates physicians/clinicians or medical assistants. Ensures that updates (e.g. cancellations or additions) are input daily into master schedule. Send requests to clinic for prescription refills and follow up with patients on messages from clinic via computerized message system. Establish and maintain effective working relationships with patients, providers, co-workers, and the public. Maintaining a calm, pleasant and compassionate tone while being able to diffuse tense situations. Follows HIPAA regulations. Perform other duties necessary or in the best interest of the department/organization. Requirements Education/Experience: High school diploma. Minimum one year experience in a medical practice and/or position encouraged. Experience in a high volume call center a plus. Other Requirements: Schedules will change as department needs change. Performance Requirements: Knowledge: Knowledge of OrthoCincy's Mission, Vision and Values. Knowledge of medical practice protocols related to scheduling appointments. Knowledge of anatomy and medical terminology. Knowledge of computerized scheduling systems. Knowledge of customer service principles and techniques. Knowledge of OSHA and safety standards. Skills: Skill in communicating effectively with providers, employees, customers and patients. Skill in maintaining appointment schedule via computerized means. Effective in critical thinking skills. Strong communication skills in a professional manner during stressful and sensitive situations with patients of all ages. Abilities: Ability to multi-task effectively Ability to communicate calmly and clearly Ability to analyze situations and respond appropriately. Ability to alternate between multiple computer systems in a timely manner. Equipment Operated: Standard office equipment. Work Environment: Standard call center workstation. Mental/Physical Requirements: Involves sitting and viewing a computer monitor 90% of the work day. Must be able to remain focused and attentive without distractions (i.e. personal devices).
    $30k-36k yearly est. 47d ago
  • Precertification and Authorization Rep-Supplemental/PRN-Remote

    Mayo Clinic 4.8company rating

    Remote job

    The Precertification and Authorization Representative is an intermediate level position that is responsible for resolving referral, precertification, and/or prior authorization to support insurance specific plan requirements for all commercial, government and other payors across hospital (inpatient & outpatient), ED, and clinic/ambulatory environments. In addition, this position may be responsible for pre-appointment insurance review (PAIR) and denials recovery functions within the Patient Access department. This may include processing of pre-certification and prior authorization for workers compensation/third party liability (WC/TPL), managed care and HMO accounts, as well as working assigned registration denials for government and non-government accounts. This role requires adherence to quality assurance guidelines as well as established productivity standards to support the work unit's performance expectations. High School Diploma or GED and 2+ years of relevant experience required OR Bachelor's degree required Additional Requirements include: Prior Auth / Authorization, Cancer Services, Microsoft Office, Radiation Oncology, Insurance Verification, Appeals, and Pre Determination experience preferred. Ability to read and communicate effectively Basic computer/keyboarding skills, intermediate mathematic competency Good written and verbal communication skills Knowledge of proper phone etiquette and phone handling skills Position requires general knowledge of healthcare terminology and CPT-ICD10 codes. Basic knowledge of and experience in insurance verification and claim adjudication is preferred. Requires excellent verbal communication skills, and the ability to work in a complex environment with varying points of view. Must be comfortable with ambiguity, exhibit good decision making and judgment capabilities, attention to detail. Knowledge of Denial codes is preferred. Knowledge of and experience using an Epic RC/EMR system is preferred. Healthcare Financial Management Association (HFMA) Certification Preferred. *This position is a 100% remote work. Individual may live anywhere in the US. **This vacancy is not eligible for sponsorship / we will not sponsor or transfer visas for this position. During the selection process, you may participate in an OnDemand (pre-recorded) interview that you can complete at your convenience. During the OnDemand interview, a question will appear on your screen, and you will have time to consider each question before responding. You will have the opportunity to re-record your answer to each question - Mayo Clinic will only see the final recording. The complete interview will be reviewed by a Mayo Clinic staff member and you will be notified of next steps.
    $44k-52k yearly est. Auto-Apply 3d ago
  • Authorization Specialist

    Seaport Scripps Home Health

    Remote job

    Pay Range: $21.00 - $25.00 per hour Schedule: Full-time, 5 days/week (8:30 AM - 5:00 PM PST) with weekend rotation or staggered schedule including one fixed weekend day About Us At Seaport Scripps Home Health, our mission is simple yet powerful: to provide LIFE CHANGING SERVICE to our patients and their families. We believe a career in healthcare is one of the noblest professions, and exceptional clinical operations leadership makes home health possible. Our team is committed to delivering superior clinical outcomes and outstanding patient and family satisfaction. Through dedication and compassion, we strive to be the provider of choice in the communities we serve. We foster a culture that values: Celebration of successes and making work enjoyable Highest standards of care and professionalism Continuous learning and growth Respect and empathy for others Innovation and good judgment And most importantly, we put employees first, because we know great care starts with a great team. Job Summary The Authorization Specialist plays a key role in ensuring smooth operations by verifying insurance eligibility, obtaining authorizations, and managing related clerical tasks. This position supports intake processes, maintains accurate clinical records, and fosters positive relationships with providers and referral sources. Key Responsibilities Verify insurance eligibility and confirm payer sources for all referrals Manage the authorization process, including monitoring calls and requests from providers Obtain and provide clinical information needed for authorizations Communicate authorization status to field and scheduling staff Provide backup support to Intake and Scheduling Coordinators Protect patient and organizational confidentiality Maintain knowledge of state, federal, and CHAP documentation regulations Qualifications Minimum 1 year of experience in insurance eligibility and authorizations (home health experience preferred) Knowledge of information systems and corporate business management Familiarity with governmental regulations Strong communication and public relations skills Ability to work independently with organization, flexibility, and cooperation About Seaport Scripps Home Health We are part of the Pennant Group, a nationwide network with 300+ locations. This gives us the stability of a proven healthcare leader while allowing us to operate locally with autonomy and innovation. Our Core Values guide everything we do: Celebration Accountability Passion for Learning Love One Another Intelligent Risk Taking Customer Second Ownership Benefits Competitive compensation Health, dental, vision, life, and disability insurance Pre-tax healthcare and dependent care flexible spending accounts 401(k) plan with generous company match Critical illness benefit Tuition reimbursement Paid time off Employee assistance program Seaport Scripps Home Health is an Equal Opportunity Employer. We evaluate qualified applicants without regard to race, color, religion, sex, national origin, disability, veteran status, or other protected characteristics. The employer for this position is stated in the job posting. The Pennant Group, Inc. is a holding company of independent operating subsidiaries that provide healthcare services through home health and hospice agencies and senior living communities located throughout the US. Each of these businesses is operated by a separate, independent operating subsidiary that has its own management, employees and assets. More information about The Pennant Group, Inc. is available at ****************************
    $21-25 hourly Auto-Apply 14d ago
  • Authorization Specialist (Remote in Wisconsin & Michigan)

    Marshfield Clinic 4.2company rating

    Remote job

    Come work at a place where innovation and teamwork come together to support the most exciting missions in the world! Job Title: Authorization Specialist (Remote in Wisconsin & Michigan) Cost Center: 101651135 Insurance Verification Scheduled Weekly Hours: 40 Employee Type: Regular Work Shift: Mon-Fri; 8:00 am - 5:00 pm (United States of America) Job Description: Wisconsin and Michigan residents only eligible to apply JOB SUMMARY The Authorization Specialist is a healthcare professional responsible for reviewing patient medical records to determine if a prescribed treatment, procedure, or medication requires prior authorization from the insurance company, ensuring that the requested care is deemed medically necessary and covered under the patient's benefits before it can be administered; this involves verifying patient eligibility, contacting insurance companies to obtain authorization, and managing the process to minimize delays in patient care. An Authorization Specialist works in a fast-paced environment with high call volumes, requiring strong organizational skills and the ability to manage multiple tasks simultaneously. JOB QUALIFICATIONS EDUCATION For positions requiring education beyond a high school diploma or equivalent, educational qualifications must be from an institution whose accreditation is recognized by the Council for Higher Education and Accreditation. Minimum Required: None Preferred/Optional: Successful completion of post-secondary courses in Medical Terminology and Diagnosis and CPT Coding, and Anatomy & Physiology. Graduate of a Medical Assistant, Health Unit Coordinator or Health Care Business Service program. EXPERIENCE Minimum Required: Two years' experience in a medical business office or health care setting involving customer service or patient-facing responsibilities, or equivalent experience. In addition to the following: * Medical knowledge: Understanding of basic medical terminology, disease processes, and treatment options to accurately assess medical necessity. * Insurance knowledge: Familiarity with different insurance plans, benefit structures, and prior authorization guidelines. * Excellent communication skills: Ability to effectively communicate with healthcare providers, insurance companies, and patients to clarify information and address concerns. * Attention to detail: High level of accuracy in data entry and review of medical records to ensure correct prior authorization requests. * Problem-solving skills: Ability to identify potential issues with prior authorization requests, navigate complex situations, and find solutions to ensure timely patient care. Preferred/Optional: None. CERTIFICATIONS/LICENSES The following licensure(s), certification(s), registration(s), etc., are required for this position. Licenses with restrictions are subject to review to determine if restrictions are substantially related to the position. Minimum Required: None. Preferred/Optional: None. Wisconsin and Michigan residents only eligible to apply Marshfield Clinic Health System is committed to enriching the lives of others through accessible, affordable and compassionate healthcare. Successful applicants will listen, serve and put the needs of patients and customers first. Exclusion From Federal Programs: Employee may not at any time have been or be excluded from participation in any federally funded program, including Medicare and Medicaid. This is a condition of employment. Employee must immediately notify his/her manager or the Health System's Compliance Officer if he/she is threatened with exclusion or becomes excluded from any federally funded program. Marshfield Clinic Health System is an Equal Opportunity/Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to sex, gender identity, sexual orientation, race, color, religion, national origin, disability, protected veteran status, age, or any other characteristic protected by law.
    $39k-46k yearly est. Auto-Apply 4d ago
  • Insurance Authorization Specialist

    Head & Neck Surgical Associate

    Remote job

    Job Description Job Summary: Obtains authorizations and referrals for surgical procedures and offsite diagnostic imaging. Creates medical and dental surgical estimates. Qualifications & Additional Characteristics: Strong interpersonal skills. The ability to relate effectively with physicians and staff, as well as outside business associates at multiple levels. Computer literate and knowledge of practice management software, insurance, and billing software. Epic knowledge preferred. Use of appropriate e-mail and internet practice applications. Basic knowledge of insurance pre-authorization process. Understanding of Managed Care contractual policies. Knowledge of CPT and ICD-10-CM coding. Oral maxillofacial surgery preferred. Responsibilities include, but are not limited to, the following: Ensures insurance carrier documentation requirements are met for pre-authorizations as it pertains to procedural and/or surgery needs. Initiates expedited reviews with payers when necessary to ensure authorization is in place prior to, or at the time of service, and communicates late notifications or risk of no auth situation to Surgery Schedulers as soon as identified. Researches and develops resources that create timely and efficient workflow. Routinely monitors cases pending or not yet started/complete, being attentive to payer specific processing time. Maintains excellent communication and positive rapport with all points of contact both internally and externally. Documents pertinent discussions and details of correspondence in all applicable systems to provide tracking and point of reference. Properly handle denied authorization cases and seek resolution through involved parties. Create medical and dental surgical estimates based on health insurance coverage. Attend all Billing Department and staff meetings. Education and Experience Requirements: High school degree or equivalent Degree and/or training in medical billing and coding Minimum of three years in the health care field Strong background and experience in understanding patient accounts as to private pay, health insurance, billing, and collection processes. Independent medical coding experience a must; Certified Medical Coder a plus. Typical Physical Demands: Work may require sitting for long periods of time, stooping, bending, and stretching. This position requires manual dexterity sufficient to operate a keyboard, computer, telephone, calculator, copier, and such other office equipment, as necessary. Employee must have normal range of hearing and eyesight. Position also requires viewing computer screens and typing for long periods of time and working in a fast-paced environment. Typical Working Conditions: Work is performed in a billing area and involves frequent contact with patients, insurance carriers and physicians. Work may be stressful at times. Monday - Friday 8am - 5pm Option to work remotely 2x per week after 90 day probationary period.
    $33k-43k yearly est. 11d ago
  • Pre-registration Specialist

    EPBH Emma Pendleton Bradley Hospital

    Remote job

    The Pre-registration Specialist is responsible for ensuring accurate and timely pre-registration of patients for scheduled services. This role includes generating estimates, communicating with patients regarding their financial obligations, securing pre-service payments or establishing payment arrangements, and ensuring all demographic and insurance information is accurate. The Pre-registration Representative/Specialist plays a critical part in optimizing financial outcomes and enhancing patient experience through effective communication and financial counseling. Brown University Health employees are expected to successfully role model the organization's values of Compassion, Accountability, Respect, and Excellence as these values guide our everyday actions with patients, customers and one another. In addition to our values, all employees are expected to demonstrate the core Success Factors which tell us how we work together and how we get things done. The core Success Factors include: Instill Trust and Value Differences Patient and Community Focus and Collaborate RESPONSIBILITIES: Pre-registration & Verification - Complete pre-registration for scheduled services, ensuring all required information is obtained and accurately entered into the system. - Verify patient insurance coverage and eligibility prior to scheduled services. - Ensure all demographic and insurance information is accurate and up to date. Financial Analytics & Patient Interaction - Generate accurate cost estimates for scheduled services based on payer contracts and patient insurance coverage. - Communicate with patients regarding their financial obligations, including co-pays, deductibles, and out-of-pocket costs. - Secure pre-service payments or establish payment arrangements prior to the date of service. - Provide clear and empathetic financial counseling to patients, ensuring understanding and satisfaction. - Interact with patients to address any questions or concerns related to their financial responsibilities. Documentation & Compliance - Maintain accurate and up-to-date records of all pre-registration activities in the electronic health record (Epic) and patient accounting systems. - Ensure compliance with HIPAA, payer guidelines, and internal policies. - Participate in audits and quality improvement initiatives as needed. QUALIFICATIONS: Education & Experience - High school diploma or equivalent required, associate or bachelor's degree in healthcare administration, finance, or related field preferred. - Minimum 2 years of experience in patient access, pre-registration, or revenue cycle operations, preferably in a healthcare setting. Skills & Competencies - Strong understanding of healthcare finance, insurance verification, and pre-registration processes. - Proficiency in generating cost estimates and communicating financial obligations. - Excellent analytical, problem-solving, and communication skills. - Ability to work independently and collaboratively in a fast-paced environment. - Experience with EHR systems (e.g., Epic, Cerner) and Microsoft Office Suite. Pay Range: $19.03-$31.39 EEO Statement: Brown University Health is committed to providing equal employment opportunities and maintaining a work environment free from all forms of unlawful discrimination and harassment. Location: Remote-Rhode Island - N/A Providence, Rhode Island 02901 Work Type: Mon-Fri Work Shift: Day Daily Hours: 8 hours Driving Required: No
    $19-31.4 hourly Auto-Apply 6d ago
  • ARM Patient Care Representative

    Keybridge Revenue Management Inc.

    Remote job

    Job DescriptionDescription: Patient Care Representative - ARM Team Hybrid/Remote Join a Best Places to Work Winner - 18 Years Running! Do you have experience with medical systems and a passion for helping others? Looking for full-time work with a company known for its award-winning culture? KeyBridge Medical Revenue Care is seeking a compassionate, detail-oriented Patient Care Representative to join our ARM team. About KeyBridge At KeyBridge, we believe exceptional patient care starts with supporting exceptional people. As an 18-time Best Places to Work winner, we're committed to compassion, integrity, and excellence. Our mission is simple: bridge the gap between healthcare providers and their patients by delivering respectful, empathetic financial care in a call-center environment. Position Overview As an ARM Patient Care Representative, you'll serve as the trusted voice of our healthcare clients-guiding patients through billing questions, assisting with payments, and helping resolve account balances. This role is the perfect blend of customer service, problem-solving, and meaningful human connection. What You'll Do Deliver exceptional service: Manage inbound and outbound calls with professionalism and empathy, assisting patients with billing questions, payment options, and account concerns. Resolve issues efficiently: Apply strong problem-solving and analytical skills to provide accurate, timely solutions while maintaining compliance and meeting performance standards. Navigate multiple systems: Work across various medical and internal systems to locate information and support patients with complex inquiries. Collaborate & communicate: Maintain clear, thorough documentation of all interactions, support team members, and help mentor new representatives when needed. Live our values: Foster trust, teamwork, and integrity with patients, clients, and colleagues every day. Requirements: What We're Looking For: Strong written and verbal communication skills, with excellent active listening Ability to multitask and work efficiently across multiple systems Experience using medical systems (billing systems such as Epic, Cerner, etc.) Proficiency with Microsoft Office (Outlook, Teams) Positive, professional attitude with a drive to succeed Ability to understand and follow written, oral, and visual instructions Prior remote-work experience Ability to pass ACA certification tests when eligible Spanish-speaking skills a plus
    $30k-39k yearly est. 18d ago
  • Patient Registration Specialist - Remote

    What We'Ll Love About You

    Remote job

    Patient Registration Specialist Hospital Registration and Check In - Remote, work from home Who We Are vRS Corporation provides virtual registration services to hospitals and clinics. In a time of shortage of staffing, changing work environments and a desire for work from home jobs, vRS has developed a system that allows medical providers to staff their registration areas through technology and onsite Virtual Interactive and Engagement Workstaions (V.I.E.W.) TM that connect to virtual registration agents working from home. Through video technology we are able to do everything an onsite in person registration specialist would be able to do. Job Summary The Patient Registration Specialist is responsible for assisting patients during the on-site registration and arrival process for scheduled and unscheduled visits as well as completing financial clearance functions. This individual completes the registration for visits by collecting accurate demographic information, insurance information, and collecting patient liability (if known) at the time of service. This individual is also responsible for financial clearance functions on assigned scheduled accounts during registration downtimes. The Patient Registration Specialist greets and serves patients and internal team members in a professional, friendly, and respectful manner to promote positive encounters. What We'll Love About You Excellent verbal and written communication skills. Excellent interpersonal and customer service skills. Excellent organizational skills and attention to detail. Education Required: High school diploma or equivalent Experience Preferred: At least 1-2 years prior registration experience Functional computer skills and comfort using different programs long with computer navigation combined with excellent typing skills. Ability to multi-task in a fast-paced environment Ability to work with a large number of people/calls daily and covering urgent requests Ability to maintain strict confidentiality Licensure/Certification/Registration CHAA preferred Why Work Here Competitive pay & Full Time 40 hours/week PTO and sick time after 90 days Individual Coverage Healthcare Reimbursement Arrangement (ICHRA) Healthcare reimbursement program for medical insurance 401k plan Company-sponsored life insurance with supplemental buy up options Great co-workers Remote Work Technical Requirements Minimum internet bandwidth requirements - Minimum requirements assume that the entire bandwidth will be available and used for the individual working from home. If other users are using the bandwidth, it is the individual's responsibility to ensure these minimum requirements are met for their work use. 25 Mbps download speed 5 Mbps upload speed Use ***************************** to test speed RTT (round trip time) 100ms or less to “AWS Workspaces US East (N. Virginia)” Please use ************************************************ to test you RTT Must be able to hardline into your home router. No Wi-Fi connections. If connection distance is more that 12 feet away from home router and network cable, it will need to be special ordered and we will need to know the specific length. Internet Service Provider (ISP) must be through Coax, DSL, or Fiber connections. No Satellite or wireless via cell phone providers is permitted. Willing to install necessary authenticator application for multi-factor authentication on your smartphone including Microsoft Authenticator App and Imprivata ID App as well as any others needed based on client access requirements. Will be required to be on camera for your shift Remote Work Physical Space Requirements Employees working remotely are required to maintain a space that is a closed space where people other than the employee will not be accessing the space during working hours and otherwise within the household cannot hear conversations going on between the employee and clients or patients. The employee can not have children or other family members present during work and will need to be able to focus on work 100%. No PHI or HIPAA data may be printed or written down in home locations. Employees need to utilize electronic resources and system to contain PHI and HIPAA data for security and compliance. Company-provided computers and equipment may not be used by anyone other than the employee and will need to be secured in a way where others do not have access to the equipment, preferably in a locked office. Employees need to have a quiet, secure work space that is free from outside noise and distractions while working in order to be able to focus on work and maintain confidentiality. We are always looking for great people to join our team. If you are passionate about customer service, enjoy working with a fantastic team, and are motivated to make a difference in patients' lives every day, then apply today with vRS! *******************************************
    $25k-35k yearly est. 60d+ ago
  • Patient Registration Specialist (Remote)

    Access Telecare

    Remote job

    Who we are: Access TeleCare is the largest national provider of telemedicine technology and solutions to hospitals and health systems. The Access TeleCare technology platform, Telemed IQ, enables life-saving patient care through telemedicine and empowers healthcare organizations to build telemedicine programs in any clinical specialty. We provide healthcare teams with industry-leading solutions that drive improved clinical care, patient outcomes, and organizational health. We are proud to be the first provider of acute clinical telemedicine services to earn The Joint Commission's Gold Seal of Approval and has maintained that accreditation every year since inception. We love what we do and if you want to know more about our vision, mission and values go to accesstelecare.com to check us out. What you'll be responsible for: We are seeking an experienced and detail-oriented Patient Registration Specialist. The Patient Registration Specialist will support the team by accurately capturing patient demographic data and insurance coverage details to ensure correct insurance billing. This role requires a strong understanding of healthcare eligibility processes and insurance verification protocols throughout the assignment. What you'll work on: Perform comprehensive patient registration, including obtaining accurate demographic and insurance information from multiple Electronic Medical Record (EMR) systems and entering this info into Access TeleCare's billing system Verify insurance eligibility and coverage benefits using payer portals, phone calls, and real-time eligibility tools Identify and resolve issues related to insurance eligibility, including coordination of benefits and out-of-network policies Escalate complex coverage or registration issues to management or the billing department as needed Maintain compliance with HIPAA and all regulatory guidelines regarding patient data and insurance handling Other duties as assigned What you'll bring to Access TeleCare: High school diploma required A minimum of 1-2 years' experience in Revenue Cycle, Registration and Medical Billing Solid understanding of registration and billing Knowledge of medical terminology, anatomy, and physiology Must also have a focus on regulatory and billing requirements Ability to maintain confidentiality Strong communications skills (written and oral) as well as demonstrate the ability to work effectively across departments Demonstrated proficiency with Microsoft office programs (Excel, Word, and PowerPoint) communication, and collaboration tools in various operating systems Ability to work effectively under deadlines and self-manage multiple projects simultaneously Strong analytical, organizational, and time management skills Flexibility, detail-oriented, and adaptability in a fast-paced environment Ability to thrive in a high growth, fast-paced organization and 100% Remote based environment Must be able to remain in a stationary position 50% of the time About our recruitment process: We don't expect a perfect fit for every requirement we've outlined. If you can see yourself contributing to the team, we would like to speak with you. You can expect up to 2 interviews via Zoom. Access TeleCare is an equal opportunity/affirmative action employer. All qualified applicants will receive consideration without regard to race, age, religion, color, marital status, national origin, gender, gender identity or expression, sexual orientation, disability, or veteran status.
    $21k-29k yearly est. Auto-Apply 35d ago

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