Top 139 Revenue enablement specialist Jobs in Columbus

Insurance Verification and Prior Auth Specialist
Ohio Gastroenterology Group —Columbus, OH
- Hybrid work
- Microsoft Excel
- HIPAA
- English
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8d
Billing Specialist
Integrated Services for Behavioral Health —Columbus, OH
- $23.85 - $28.02 an hour
- Full-time
- Hybrid work
- Mid-level
- 3 years
- Disability insurance
- Health insurance
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Noregon Sales Professional
Noregon Systems Inc —Columbus, OH
- Extended hours
- Background check
- Dealership
- Computer literacy
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Senior Financial Advisor - Experienced Professionals
First Command —Columbus, OH
- Full-time
- 5 years
- Military
- Financial services
- Flexible schedule
14h
Professional Land Surveyor - OH
Blew & Associates, P.A. —Columbus, OH
- $90,000 - $150,000 a year
- Full-time
- Remote
- Research
- Mid-level
- Communication skills
- Paid parental leave
- Paid holidays
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Leasing Professional
Greystar Real Estate Partners LLC —Westerville, OH
- $18 - $19 an hour
- Full-time
- Background check
- Sales
- Customer service
- Paid parental leave
- Paid holidays
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2d
Small Business Specialist 3 - Hilliard, OH Area
U.S. Bank National Association —Galloway, OH
- $25.63 - $37.60 an hour
- Full-time
- Mid-level
- Office
- 3 years
- Paid holidays
- Disability insurance
Account Resolution Specialist
Weltman, Weinberg & Reis Co., LPA —Dublin, OH
- $18.29 - $22.04 an hour
- Background check
- Spanish
- Computer literacy
- Free parking
- Paid holidays
Quick Apply
9d
Operational Business Specialist
DHL —Westerville, OH
- Full-time
- Oracle
- Mid-level
- Office
- Paid holidays
- Health insurance
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Sales Enablement Communications Specialist
U.S. Bank National Association —Columbus, OH
- $92,820 - $109,200 a year
- Full-time
- Office
- 8 years
- Bachelor's degree
- Paid holidays
- Disability insurance
8d
Clinical Specialist
PROCEPT BioRobotics Corporation —Columbus, OH
- $108,000 a year
- Full-time
- Bachelor's degree
- Operating room
- Travel
- Opportunities for advancement
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7d
Commercial Lines Quality Assurance Specialist (hybrid/remote)
Grange Insurance Company —Columbus, OH
- Remote
- 5 years
- Analysis skills
- Bachelor's degree
- Bereavement leave
9d
Administrative Specialist
Miller Pipeline —Columbus, OH
- Overtime
- Office
- High school diploma or GED
- Business
- Opportunities for advancement
Global Communications Experienced Specialist
Deloitte —Columbus, OH
- 5 years
- Office
- SharePoint
Quality Assurance Specialist
Klarna Bank AB —Columbus, OH
- $75,281 - $84,315 a year
- Full-time
- English
- Finance
- Analysis skills
- Health insurance
- Dental insurance
7d
Senior Revenue Recovery Specialist
Ensemble RCM LLC —Columbus, OH
- $22.45 - $24.70 an hour
- Full-time
- Customer service
- 5 years
- Office
- Tuition reimbursement
11d
Logistics Specialist
Vertiv —Westerville, OH
- Spanish
- Computer Science
- Mid-level
Digital Enablement Specialist
TechBiz Global GmbH —Columbus, OH
- Full-time
- Remote
- Mid-level
- 3 years
- Communication skills
Quick Apply
Senior Specialist, Creator Marketing (HCo)
Abercrombie & Fitch Co. —New Albany, OH
- Full-time
- Marketing
- Office
- 3 years
- Store discount
- Paid parental leave
7d
Health Information Management Specialist
Equitas Health, Inc. —Columbus, OH
- Weekends as needed
- Hybrid work
- HIPAA
- Research
- Mid-level
Quick Apply

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Insurance Verification and Prior Auth Specialist

Ohio Gastroenterology Group -
Columbus, OH

Quick Apply

Job Details

8 days ago

Qualifications

High school diploma or GED

Full Job Description

Primary Job Functions[1] (#_ftn1):

Ensures information obtained is complete and accurate, applying acquired knowledge of Medicare, Medicaid, and third-party payer requirements/on-line eligibility systems.
Contacts insurance carriers to obtain benefit coverage, policy limitations, authorization/notification, and pre-certifications for patients. Follows up with internal departments, physician offices, patients and third-party payers to complete the pre-certification process.
Identifies out of pocket amounts (i.e., copay, deductible, co-insurance), determining the correct coordination of benefits, identifying if a replacement or supplemental plan exists, identifying termed coverage, and identifying if the patient's plan is considered out of network coverage.
Collaborates with internal departments to provide account status updates, including expected out of pocket amounts, coordinate the resolution of issues, and appeal denied authorizations.
Ensures services have prior authorizations and updates patients on their preauthorization status. Coordinates peer to peer review if required by insurance. Notifies ordering providers if authorization/certification is denied.
May need to coordinate scheduling of patient appointments, diagnostic and/or specialty appointments, tests and/or procedures.
Maintains files for referral and insurance information, and enters referrals into the system.
Maintains knowledge of and reference materials of the following: Medicare, Medicaid and third-party payer requirements, guidelines and policies, insurance plans requiring pre-authorization and a list of current accepted insurance plans.
Runs system-generated reports to verify insurance verification/authorization is being done timely prior to the patient's date of service; verifies the insurance benefits and eligibility either by phone or online for every patient that is scheduled
Responds to patient calls about how out of network insurance is handled and provide patient with letter explaining this if necessary.
May need to respond to patient inquiries about their insurance benefits.
Assists physician’s office staff with any insurance benefit questions and educate them on any changes to the insurance companies’ verification/pre-certification process for the facility.
Ensures insurance information is verified and entered into the billing system.
Works with Billing Department to assure all insurance information is entered so claims are not denied. May help research any claim issues.
Other duties as assigned.

Secondary Job Functions:

Attend meetings and training sessions
Maintain confidentiality of patient and financial information by utilizing HIPAA guidelines and regulations
Adheres to all Federal, State, and Local laws and regulations as well as policies set forth by Ohio Gastroenterology Group Inc and its related parties

Knowledge, Skills and Abilities

Knowledge of third-party payers and prior-authorization requirements
Understanding of basic medical terminology and procedures
Proficient use of office equipment, such as copier and fax machine, phones, etc.
Intermediate computer skills including use of Microsoft Office (Excel and Word), electronic mail, payer websites, physician practice management, and electronic medical records systems.
High attention to detail and the ability to multi-task.
Strong time management skills
Ability to work independently with minimal supervision and to manage multiple priorities.
Strong written and verbal communication skills
Ability to effectively communicate with a variety of people under stressful circumstances.

Neat appearance, professional demeanor and pleasant voice
Fluent in English

Credentials and Experience

Must have high school diploma or equivalent
One (1) year of experience and relevant knowledge of revenue cycle functions, insurance eligibility, or prior authorization in a healthcare setting preferred
- Experience with eClinicalWorks a plus

Physical Demands

Must be able to bend over (frequent), climb stairs (frequent), sit (frequent), stand (frequent), stoop (frequent), walk (frequent) and type on keyboard (frequent).

Work Environment

Minimal medical office exposure that may require contact with adult patients
Office workstation environment with numerous employees

[1] (#_ftnref1) Critical features of this job are described under this heading. They may be subject to change at any time due to reasonable accommodation or other reasons,

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 (https://www.eeoc.gov/poster) notice from the Department of Labor.

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Refine Your Search

revenue enablement specialist jobs in columbus

Insurance Verification and Prior Auth Specialist

Billing Specialist

Noregon Sales Professional

Senior Financial Advisor - Experienced Professionals

Professional Land Surveyor - OH

Leasing Professional

Small Business Specialist 3 - Hilliard, OH Area

Account Resolution Specialist

Operational Business Specialist

Sales Enablement Communications Specialist

Clinical Specialist

Commercial Lines Quality Assurance Specialist (hybrid/remote)

Administrative Specialist

Global Communications Experienced Specialist

Quality Assurance Specialist

Senior Revenue Recovery Specialist

Logistics Specialist

Digital Enablement Specialist

Senior Specialist, Creator Marketing (HCo)

Health Information Management Specialist

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