Prior Authorization Specialist – Case Management Solutions – Englewood Cliffs, NJ

We are a rapidly growing case management company servicing skilled nursing homes, and we would love for you to join our team!

Full Time 9:00 am to 5:00 pm Monday – Friday, Location is in Englewood Cliffs New Jersey.


Essential Duties and Responsibilities:

  • Navigate through our Preparatory Software and other medical Software’s
  • Thoroughly review all daily censuses for all designated facilities 100%
  • Notify Insurance of Admissions and Discharges
  • Send Clinical Updates to the insurance regularly
  • Respond to high volume of incoming and outgoing calls, emails, and voicemails from the facilities or insurances
  • Attend Virtual UR Meetings
  • Request highest reimbursement rate appropriately and in a timely manner
  • Monitor and communicate denials in a timely manner
  • Document all communications throughout the day


Requirements:

  • Insurance Authorization 1 year
  • High school or equivalent
  • Strong written and verbal communication skills
  • Friendly and good customer service skills
  • Knowledge in insurance verification and eligibility
  • Basic Medical Terminology
  • Organized and strong attention to details
  • Punctual

Compensation and Benefits:

Case Management Solutions offers a competitive salary and excellent benefits, including a substantial medical/dental/vision insurance subsidy, generous holiday/vacation policy

Finalist candidate(s) for this position will be subject to a pre-employment background check as a condition of employment.

Source: Indeed.com
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