This is a remote position.
About our Client:
OpenLoop was co-founded by CEO, Dr. Jon Lensing, and COO, Christian Williams, with the vision to bring healing anywhere. Their telehealth support solutions are thoughtfully designed to streamline and simplify go-to-market care delivery for companies offering meaningful virtual support to patients across an expansive array of specialties, in all 50 states.
Job Summary:
OpenLoop is looking for a Prior Authorization Specialist to join their team remotely. This role will be a member of the Revenue Cycle Management Team, reporting to the RCM Director.
Responsibilities:
- Verify insurance coverage and eligibility
- Interpret physician orders, medical terms and insurance details to process authorizations
- Contact providers as necessary, gathering clinical information needed for insurance providers
- Partner with Billing to accurately code services to ensure expedient approvals and payments
- Obtain insurance authorizations via telephonic and online payer systems
- Secure medical necessity checks in accordance with Medicare, Medicaid, and private payer guidelines
- Partner with clinicians to complete patient registration, educating patients on financial liabilities - working cross functionally
- Perform online data entry of routine authorizations and denials
- Other admin duties as assigned
Requirements
- 1+ years experience in a customer service role required
- 1+ years of remote work experience required
- Prior Authorization Specialist 2
- 1-2 years of experience in a similar role preferred
- With experience using JIRA Service Desk and Zendesk
- Familiarity using various systems for eligibility checks such as Availity and Insomniapreferred
- Ability to work in a fast paced environment and pivot as needs change
- Knowledge of function and relationships within hospitals or medical offices preferred
- Understanding of third party payor requirements preferred
- Must be able to complete job duties while seated at desk for multiple hours
- Must have Fiber Optic internet with at least 25 Mbps bandwidth
- Must have a backup desktop or laptop with the latest OS
- Must be able to work from 10PM-7AM
- Must be amenable to work in-office
Benefits
WHAT WE OFFER:
Great Place to Work-Certified Company
Premium HMO
Holistic employee experience
Work-from-home and hybrid work setup
Rewards and incentives
Monthly engagement activities
Career advancement opportunities
Paid referral program