Top 19 Prior authorization specialist Jobs in Rio Rancho, Nm

Prior Authorization Specialist
New Mexico Cancer Center —Albuquerque, NM
- Full-time
- Surgery
- Computer literacy
- Basic math
- Health savings account
- Health insurance
Quick Apply
Patient Access Account Specialist
Presbyterian Healthcare Services —Albuquerque, NM
- $16.38 - $25.57 an hour
- Full-time
- Hybrid work
- Hospital
- Customer service
- HIPAA
- Disability insurance
- Health insurance
Quick Apply
2d
Patient Access Account Specialist
Presbyterian System Services —Albuquerque, NM
- $16.38 - $25.57 an hour
- Full-time
- Hospital
- HIPAA
- High school diploma or GED
- Disability insurance
- Health insurance
Quick Apply
Prior Authorization Specialist
Southwest Womens Oncology/Optimum —Albuquerque, NM
- Full-time
- HIPAA
- Clinic experience
- Mid-level
- Health insurance
- 401(k)
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Patient Visit Specialist
Presbyterian System Services —Rio Rancho, NM
- $16.79 - $27.67 an hour
- Full-time
- Hospital
- Medical office experience
- HIPAA
- Disability insurance
- Health insurance
Quick Apply
2d
Patient Access Account Specialist I
Presbyterian Healthcare Services —Rio Rancho, NM
- $16.38 - $25.57 an hour
- PRN
- Hospital
- Mid-level
- High school diploma or GED
- Disability insurance
- Health insurance
Quick Apply
2d
Medical Scribe
Oak Street Health —Albuquerque, NM
- $17.00 - $28.46 an hour
- Full-time
- Computer literacy
- HIPAA
- Clinic
- Health insurance
- Dental insurance
4d
Medical Scribe
Oak Street Health —Albuquerque, NM
- $17.00 - $28.46 an hour
- Full-time
- Computer literacy
- HIPAA
- Clinic
- Health insurance
- Dental insurance
Medical Scribe
Oak Street Health —Albuquerque, NM
- $17.00 - $28.46 an hour
- Full-time
- Computer literacy
- HIPAA
- Clinic
- Health insurance
- Dental insurance
4d
Pre-Certification Specialist
NEW MEXICO ORTHOPAEDIC ASSOCIATES P C —Albuquerque, NM
- Overtime
- Ability to walk for extended periods
- Medical office experience
- Basic math
Prior Authorization Specialist
X-Ray Associates of New Mexico —Albuquerque, NM
- Full-time
- Medical office experience
- Mid-level
- High school diploma or GED
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Pharmacy Prior Authorization Specialist
Onco360 —Albuquerque, NM
- From $23 an hour
- Full-time
- Customer service
- HIPAA
- Mid-level
- Paid holidays
- Disability insurance
Quick Apply
14d
Front Desk - Patient Service Specialist
NEW MEXICO ORTHOPAEDIC ASSOCIATES P C —Albuquerque, NM
- Weekends as needed
- Basic math
- Physical & Rehabilitation Medicine
- HIPAA
6d
Office Support Staff - Full-time
New Mexico Solutions —Albuquerque, NM
- $15.33 - $16.86 an hour
- Full-time
- Spanish
- CPR Certification
- Microsoft Excel
- Mileage reimbursement
- Paid holidays
Quick Apply
Home care manager - Claims & Operations Specialist
All About You Home Healthcare —Albuquerque, NM
- $18 - $22 an hour
- Part-time
- HIPAA
- Mid-level
- Office
Quick Apply
9d

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Prior Authorization Specialist
New Mexico Cancer Center —Albuquerque, NM
If PA is needed – submits online/calls/faxes the needed information to the payer and follows up for a response. One - Two years related experience.
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Medical Scribe
Oak Street Health —Albuquerque, NM
Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.
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prior authorization specialist jobs near rio rancho, nm

Prior Authorization Specialist

New Mexico Cancer Center -
Albuquerque, NM

Quick Apply

Job Details

Full-time

Benefits

Health savings account
Health insurance
Dental insurance
401(k)
Flexible spending account
Paid time off
Employee assistance program
Vision insurance
Life insurance

Qualifications

Medical documentation
Medicare
Computer literacy
High school diploma or GED
ICD-10
HCPCS
Medical billing

Full Job Description

New Mexico Oncology Hematology Consultants Ltd. is seeking a caring, compassionate, and patient orientated Prior Authorization Specialist.

We are, a freestanding, physician-owned, comprehensive cancer center based in Albuquerque, NM with a satellite clinic in Gallup, New Mexico. We are an Oncology Medical Home, with a focus on early intervention for patient symptoms, resulting in low hospitalization rates. Our Physicians have won Top 10 Docs in the city of Albuquerque multiple times.

As a successful Medical oncology and Radiation oncology practice, we have expanded our medical practice to include Survivorship, Palliative Care, Primary Care, Rheumatology, Pulmonary, Urology, Breast Surgery and Neurology.

Make a difference in the lives of patients by joining a physician-led, partnership organization with a patient-centered and evidenced-based medicine approach. You will have the tools, resources, and professional freedom you need to deliver outstanding patient care.

POSITION SUMMARY:

Prior Authorization Specialists are responsible for ensuring procedures, CT’s, MRI’s, PET Scans, infusions, injections, drugs radiation and genetic testing are Prior Authorized and meets Medical Necessity requirements as defined by Medicare or private insurance. This position will also ensure and perform duties that help the organization achieve its mission, vision while demonstrating and adhering to the core values.

ESSENTIAL FUNCTIONS:

Reasonable Accommodations Statement:

To perform this job successfully, an individual must be able to perform the essential duties satisfactorily. Reasonable accommodations may be made to enable qualified individuals with disabilities to perform the essential functions.

Essential Functions Statement(s):

Searches tasks and schedules in OncoEMR, ARIA RO and the radiology system (Medinformatics) as appropriate, up to 14 days in advance and determine the service that may need authorization.
Utilizes portals and/or initiate calls to the payers and determine if services require a prior authorization based on the CPT/HCPCS codes.
Uses the resources available to determine if the service meets Medical Necessity by following Medicare NCD’s, LCD’s and payer policies
If PA is needed – submits online/calls/faxes the needed information to the payer and follows up for a response. If the payer requires medical records – these will be sent.
Documents prior authorizations and obtains the electronic or payer copy of approvals and scan into EMR or PM system as appropriate. Notes should be detailed and contain all information, including reference numbers.
Works with the provider to schedule peer to peer and appeals to overturn denials of prior authorizations. If unable to get denial overturned, contacts the provider and clinic staff on status of patient, will they be self-pay, Medicare patients need an ABN signed if they still decided to continue with the exam. If the denial is not overturned, communicate with the appropriate staff to inform the provider of other alternatives covered under the plan.
Checks prior authorizations for all “add-on” patients daily and should be processed in an urgent manner.
Inform Leadership if trends are identified or changes in prior authorizations processes.
Obtains updates on a regular basis for CPT/HCPCS, ICD-10 and coding from Medicare and other payer websites.

SKILLS & ABILITIES:

Education and Experience:

High School Graduate or General Education Degree (GED).
One - Two years related experience.
Knowledge of CPT/HCPCS codes.
Experience and knowledge of healthcare insurance prior authorization/coding.
Ability to read, interpret and understand documents such as operating and maintenance instructions, and policy and procedure manuals.
Ability to add, subtract, multiply and divide in all units of measure, using whole numbers.

Computer Skills:

Basic computer skills, Electronic Medical Records (EMR) & Billing Software.

Certificates & Licenses:

None

Compensation/Benefits

Competitive Pay D.O.E.
Generous Benefits Package

Job Type: Full-time

Benefits:

401(k)
Dental insurance
Employee assistance program
Flexible spending account
Health insurance
Health savings account
Life insurance
Paid time off
Vision insurance

Education:

High school or equivalent (Preferred)

Experience:

Medical billing: 1 year (Preferred)
Prior Authorization: 1 year (Preferred)

Work Location: In person

Quick Apply

Refine Your Search

prior authorization specialist jobs in rio rancho, nm

Prior Authorization Specialist

Patient Access Account Specialist

Patient Access Account Specialist

Prior Authorization Specialist

Patient Visit Specialist

Patient Access Account Specialist I

Medical Scribe

Medical Scribe

Medical Scribe

Pre-Certification Specialist

Prior Authorization Specialist

Pharmacy Prior Authorization Specialist

Front Desk - Patient Service Specialist

Office Support Staff - Full-time

Home care manager - Claims & Operations Specialist

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