Prior Authorization Specialist

Nationwide Children's Hospital • Columbus, OH

14h

About The Position

Overview: Schedule: M-F (Day shift, 40 hours per week) This is a temporary position without guarantee of conversion to full-time employment. Job Description Summary: Coordinates patient accounts from prior authorization to point of bill payment or referral to collection, including processing billing for home health agencies to appropriate agencies, including Medicaid and self-pay. Maintains current knowledge of changes in billing requirements and regulations and assists in resolving billing problems. Job Description: Essential Functions: Verifies patient insurance coverage and eligibility for homecare services. Processes and submits insurance claims for reimbursement. Communicates with patients, insurance companies, and healthcare providers to resolve billing issues. Maintains accurate and up-to-date patient records and billing information. Monitors and tracks outstanding claims and follows up on unpaid or denied claims. Ensures compliance with all relevant regulations and guidelines related to homecare billing and reimbursement.

Requirements

• High School Diploma or equivalent, required.
• Two years of experience billing public and private insurers for medical services using computerized billing system, required.

Nice To Haves

• Homecare services experience, preferred.

Responsibilities

• Verifies patient insurance coverage and eligibility for homecare services.
• Processes and submits insurance claims for reimbursement.
• Communicates with patients, insurance companies, and healthcare providers to resolve billing issues.
• Maintains accurate and up-to-date patient records and billing information.
• Monitors and tracks outstanding claims and follows up on unpaid or denied claims.
• Ensures compliance with all relevant regulations and guidelines related to homecare billing and reimbursement.

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: High school or GED