Prior Authorization Specialist Job at Hart Medical Equipment, Grand Blanc, MI

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  • Hart Medical Equipment
  • Grand Blanc, MI

Job Description

Hart Medical Equipment provides a full range of home care products and support services based on individual needs. We strive to conduct our patient care operation with the highest standards. We are a nationally accredited, premier provider of home medical equipment and supplies.

Status: Full Time

Hart Medical Equipment offers a competitive salary and benefits package. EOE

SUMMARY: Supports the billing department with functions such as insurance changes and prior authorizations to ensure a complete billing transaction.

ESSENTIAL DUTIES AND RESPONSIBILITIES: Reasonable accommodations may be made to enable individuals with disabilities to perform these essential functions.

  • Maintains current knowledge on Medicare, Medicaid, and third party payer sources for equipment coverage.
  • Verifies medical necessity, insurance coverage and physician orders for all insurance-assigned services.
  • Maintains accurate records for certification of medical necessity and prior authorization forms.
  • Follows department policies and work instructions to insure billing metrics are being met.
  • Maintain current manuals including insurance regulations, company procedures, office memos and correspondence.
  • Responsible for reporting updates on vital information to appropriate management.           
  • Keeps management informed of changes that affects accounts receivable.
  • Communicates with physicians/patients as needed.
  • Other duties as requested by Management.

SUPERVISORY RESPONSIBILITES

This position does not have any supervisory responsibilities.

QUALIFICATIONS

To perform this job successfully, an individual must be professional, proactive and positive with internal and external customers and coworkers. The requirements listed below are representative of the knowledge, skill, and/or ability required.

Education and/or Experience

  • High school diploma or general education degree (GED).
  • Minimum of six (6) months in a medical related field and/or training; or equivalent combination of education and experience.

Skills & Abilities

  • Excellent interpersonal, written and verbal communication skills.
  • Attention to detail
  • Good data entry skills
  • Proficiency with computers, with strong typing skills.
  • Good organization skills

Language Skills

English (verbal, written)

Mathematical Skills

Ability to add, subtract, multiply, and divide in all units of measure using a calculator.

Analytical & Problem Solving Ability

Ability to apply common sense understanding to carry out instructions furnished in written, oral, or diagram form. Ability to deal with problems involving several concrete variables in standardized situations.

CERTIFICATES, LICENSES, REGISTRATIONS

None
PHYSICAL DEMANDS

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. 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 and hear. The employee is occasionally required to stand and walk. The employee must occasionally lift and/or move up to 25 pounds. Specific vision abilities required by this job include close vision. All employees are required to work in a safe manner.

WORK ENVIRONMENT

The work environment described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Office environment with moderate level noise.

TRAINING

Orientation and selected courses must be completed in the designated time frame.

ADDITIONAL QUALIFICATIONS

None

Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities and activities may change at any time with or without notice.

By submitting an application, you are agreeing to the terms of Hart's Application Acknowledgement and Agreement found at .

IRB Medical Equipment LLC, dba Hart Medical Equipment, is an equal opportunity employer and does not discriminate on the basis of race, color, religion, sex, national origin, citizenship age, disability genetic information, height, weight, marital or veteran status or any other protected status in accordance with the requirements of applicable federal state and local laws. Hart Medical Equipment also provides reasonable accommodation for individuals with disabilities in accordance with applicable law.

Job Tags

Full time, Local area,

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