Rev Cycle Specialist (Prior Authorizations)

Rev Cycle Specialist (Prior Authorizations)Role and Responsibilities:Identifies all appointments and procedures that require prior-authorization by monitoring system reportsReviews patient diagnoses and medical notes/laboratory reports required for prior-authorizations submissionsAccountable for knowledge of updated drug and procedure prior-authorization requirements, relating to all commercial insurance carriersCommunicates with Insurance carriers by phone for cases of urgency, down systems, research/clarifications or troubleshootingIndependently maintains and updates multiple reports on all upcoming patient appointments and prior-authorizationsMaintains patient confidentialityUtilizes insurance portals to submit prior-authorizationsTroubleshoots prior-authorization cases for insurancesManages a high-volume demand for prior-authorizations with accuracyAttends and participates in NJ Retina / or payer meetings/seminars as neededMaintains open, positive cordial, team-oriented lines of communications with managers and staff membersContributes to the Business office team thought, positive attitude, respectful interaction, innovative ideas and efficientlyOther duties as assignedEssential Qualifications:Education: High School Diploma or equivalent; Bachelor's degree preferred.Experience: 1+ years' experience in an administrative role; medical billing experience within Ophthalmology preferred but not required.Knowledge/Skills/Experience:Working knowledge of prior-authorization processExperience with Medicare, insurances, claims, appealsKnowledge of CPT, ICD-9 and/or ICD-10 codes a plusProven customer service skillsAble to work in a high volume/fast-paced environmentExcellent written and verbal communication skillsOutstanding attention to detail and excellent time management skillsOutstanding typing and computer skills with billing software, Microsoft Word and Microsoft ExcelAbility to work with sensitive and confidential informationHourly Pay Range- $21.8500 to $25.00 USDAt PRISM Vision Group, we believe great work deserves great rewards. Here's what you can expect when you join our team:Competitive Compensation Base salary, performance bonuses, and regular reviews.Health & Wellness Comprehensive medical, dental, and vision insurance; and wellness program.Retirement Planning 401(k) with company match.Generous Time Off Paid vacation, sick leave, and company holidays.Learning & Development career growth programs.Other Perks Commuter benefits, Voluntary Accident and Critical Illness plans, FSA/HSA and Dependent Care FSA. employee discounts, and more.Equal Opportunity Employer This employer is required to notify all applicants of their rights pursuant to federal employment laws. For further information, please review the Know Your Rights notice from the Department of Labor.