This position is responsible for efficiently requesting prior authorizations (“PAR”) with insurance companies.
Efficiently make PAR requests to insurance payors as required for approval for service of patients
Obtain and chart accurate PAR information required for billing a ‘clean claim’
Request authorization extensions as required
Follow up on authorization denials and appeal with necessary documentation
Identify new and expired authorizations
Resolve held invoices and stopped orders due to missing/expired authorizations
Assist with rush authorization requests from AdaptHealth personnel
Correctly follow WIP procedures for sales orders with a valid PAR for service.
Working knowledge of Microsoft Office (Mail, Word, Excel) and Internet browsing.
Well organized, detailed oriented with excellent follow-through.
Ability to complete tasks within a given time frame. Fosters a sense of urgency and follow through to resolve outstanding issues in a timely manner.
Works well with others regardless of their level or background; is respectful; maintains positive relationships even under stressful or difficult circumstances; deals with different points of view or disagreements in a constructive, successful manner.
Ability to function well while involved in multiple task assignments and in a fast-paced environment.
Anticipates and prepares for short and long-term challenges/trends; sees how his/her work relates to others as well as the organization as a whole; understands implications of decisions; translates ideas and concepts into practical applications.
Language: Intermediate ability to read and interpret documents such as safety rules, operating and maintenance instructions, and procedure manuals. Ability to write routine reports and correspondence.
College graduate or equivalent, preferably RN but not required
Medical terminology and medical insurance industry experience preferred
Experience with Brightree software preferred
Familiarity with home medical equipment and related supplies preferred
Knowledge of major insurance carrier reimbursement guidelines and coverage (preferred)
While performing the duties of this job, the employee is occasionally exposed to the following conditions: work near moving mechanical parts. The noise level in the work environment is usually moderate. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
While performing the duties of this job the employee is regularly required to sit, talk, hear and use hands. The employee is occasionally required to stand, walk, reach with hands and arms, stoop, kneel, crouch, crawl, taste/ smell, and lift/move (up to 25 lbs). Specific vision abilities required by this job include close vision, distance vision, peripheral vision, depth perception, and ability to adjust focus. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
Questions? Contact careers@agilitystaffingservices.com
