Reauthorization Specialist - Infusion at PROMPTCARE COMPANIES INC

Lenexa, Kansas, United States -

Full Time

Start Date

Immediate

Expiry Date

03 Feb, 26

Salary

0.0

Posted On

05 Nov, 25

Experience

2 year(s) or above

Remote Job

Yes

Telecommute

Yes

Sponsor Visa

Skills

Healthcare Insurance, Communication Skills, Medical Reimbursement, Microsoft Office Suite, CPR+ Software, Caretend, Authorization Requests, Patient Contact, HIPAA Compliance, Team Player, Insurance Plan Requirements, Medical Terminology, Documentation, Follow-Up, Problem Resolution, Quality Reviews

Industry

Hospitals and Health Care

Description

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 Job Type: Full-time, 40 hours per week, Mon-Friday 8:00am - 4:30pm (Flexible) Location: Hybrid out of Lenexa, KS (open to remote) 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 Comprehensive Medical, Dental, and Vision Package 401(k) Plan with Company Match Generous PTO: Vacation, Sick Time, Personal Days, and Paid Holidays Life Insurance: Standard coverage with optional enhancements Employee Assistance Program: Free counseling and coaching sessions Emotional Well-being and Work-Life Balance Resources Short & Long-Term Disability: Company-paid with optional supplements Accidental Death and Dismemberment Insurance FSA and HSA: Manage healthcare expenses Commuter Spending Programs Employee Bonus Referral Volunteer and Engagement Opportunities 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.

Responsibilities

The Reauthorization Specialist will initiate and manage insurance authorizations for infusion therapy services, ensuring timely follow-up on pending authorizations. They will also review authorization approvals and denials, documenting all communications and maintaining patient confidentiality.