Top 10 Specialist authorization denial Jobs in Columbus

BH Insurance/Precert Specialist
Nationwide Children's Hospital —Columbus, OH
- Full-time
- CPR Certification
- BLS Certification
- High school diploma or GED
Utilization Review Specialist - Autism
Nationwide Children's Hospital —Columbus, OH
- Full-time
- Customer service
- Writing skills
- Mid-level
- Work from home
4d
Revenue Cycle & Prior Authorization Specialist
360 Vascular Institute —Dublin, OH
- $20 - $25 an hour
- Part-time
- Hybrid work
- Background check
- Private practice
- Customer service
- Health insurance
- Dental insurance
Quick Apply
1d
Medical Billing and Accounts Receivable Specialist
I Am Boundless, Inc. —Worthington, OH
- Full-time
- Remote
- Computer literacy
- Mid-level
- Microsoft Office
Quick Apply
Specialist, Utilization Review
Columbus Springs East —Columbus, OH
- Full-time
- CPR Certification
- Management
- BLS Certification
- Disability insurance
- Health insurance
Quick Apply
Billing Specialist
Forward Health —Columbus, OH
- Full-time
- HIPAA
- Mid-level
Quick Apply
Outpatient Navigator
Mount Carmel Behavioral Health —Columbus, OH
- Full-time
- LMFT
- Psychiatry
- Hospital
12d

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Utilization Review Specialist - Autism
Nationwide Children's Hospital —Columbus, OH
Bachelor’s Degree in Social Work, Psychology, or related field, required. Documents all case reviews and maintains accurate records of all clinical activities…
4d

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BH Insurance/Precert Specialist
Nationwide Children's Hospital —Columbus, OH
CPR certification (based on position and as determined by manager). Assists with the retrospective review of records for patients who have insurance changes…
Utilization Review Specialist - Autism
Nationwide Children's Hospital —Columbus, OH
Bachelor’s Degree in Social Work, Psychology, or related field, required. Documents all case reviews and maintains accurate records of all clinical activities…
4d

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BH Insurance/Precert Specialist

Nationwide Children's Hospital -
Columbus, OH

Apply Now

Job Details

Full-time

Qualifications

High school diploma or GED
Computer skills

Full Job Description

Overview:

Schedule: M-F (Day Shift)

On-site during probation period until cleared to work remote.

Job Description Summary:

Verifies and documents benefit information. Requests initial authorization and meets provider’s referral requirements to ensure that optimum payment is made to the hospital and providers.

Job Description:

Essential Functions:

Contacts insurance companies to obtain and verify benefit information, documents all benefit information, and meets payer’s referral requirements to ensure that optimum payment to the hospital and providers will be satisfied.
Obtains insurance prior authorization as needed and documents the verification of benefits and prior authorizations in Epic. Maintains record of pending prior authorizations and documents timely follow-up.
Assists with the retrospective review of records for patients who have insurance changes that impact the authorization.
Communicates authorization denials and appeal options to referral sources/Providers. Assists with coverage resources as appropriate.
Contacts schedulers if insurance cannot be verified and refers self-pay patients to financial assistance resources.
Participates in department and interdepartmental meetings to promote knowledge, troubleshoot, and resolve issues related to benefits or authorizations.
Maintains knowledge of The Joint Commission, Medicaid, Medicare, and other third-party payer standards and requirements.

Education Requirement:

High school graduate, required.

Associate’s Degree, preferred.

Licensure Requirement:

(not specified)

Certifications:

CPR certification (based on position and as determined by manager).

Skills:

Strong computer skills required with the ability to navigate most current technology systems.

Excellent written, communication, and organizational skills required.

Experience:

One year previous health care or insurance experience preferred.

Physical Requirements:

OCCASIONALLY: Bend/twist, Biohazard waste, Blood and/or Bodily Fluids, Chemicals/Medications, Communicable Diseases and/or Pathogens, Driving motor vehicles (work required) *additional testing may be required, Lifting / Carrying: 0-10 lbs, Lifting / Carrying: 11-20 lbs, Loud Noises, Patient Equipment, Pushing / Pulling: 0-25 lbs, Reaching above shoulder, Squat/kneel, Standing, Walking

FREQUENTLY: Flexing/extending of neck, Hand use: grasping, gripping, turning

CONTINUOUSLY: Audible speech, Color vision, Computer skills, Decision Making, Depth perception, Hearing acuity, Interpreting Data, Peripheral vision, Problem solving, Repetitive hand/arm use, Seeing – Far/near, Sitting

Additional Physical Requirements performed but not listed above:

Able to multi-task within in a stressful environment.

"The above list of duties is intended to describe the general nature and level of work performed by individuals assigned to this classification. It is not to be construed as an exhaustive list of duties performed by the individuals so classified, nor is it intended to limit or modify the right of any supervisor to assign, direct, and control the work of employees under their supervision. EOE M/F/Disability/Vet"

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Refine Your Search

specialist authorization denial jobs in columbus

BH Insurance/Precert Specialist

Utilization Review Specialist - Autism

Revenue Cycle & Prior Authorization Specialist

Medical Billing and Accounts Receivable Specialist

Specialist, Utilization Review

Billing Specialist

Outpatient Navigator

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