Top 723 Enable healthcare inc. Jobs in Remote

Prior Authorization Specialist
Koya Medical, Inc. —Remote
- $55,000 - $60,000 a year
- Full-time
- Remote
- HIPAA
- Mid-level
- 3 years
Quick Apply
2d
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US Anesthesia Partners, Inc. —Remote
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- Microsoft Outlook
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Poppins, Inc. —Remote
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- Google Workspace
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Verily —Remote
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Inspira Financial Trust, LLC —Oak Brook, IL
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- Monday to Friday
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CareQuest Institute for Oral Health Inc —Remote
- $91,630 - $107,800 a year
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Validation Representative, MVA
EnableComp —Remote
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(PT) Crisis Line Worker- Chicago ( Remote) Bi-lingual preferred
AUNT MARTHAS HEALTH AND WELLNESS INC —Olympia Fields, IL
- $20.00 - $20.35 an hour
- Part-time
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- Spanish
- HIPAA
- English
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Senior Manager, Compliance
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- 7 years
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Underpayment Analyst, Denials - Zero Balance (REMOTE)
EnableComp —Remote
- Full-time
- Remote
- Microsoft Outlook
- Customer service
- Computer literacy
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Business Analyst ( Remote ) ( Healthcare )
AssistRx —Orlando, FL
- Full-time
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- Background check
- 7 years
- Microsoft Outlook
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Xanitos Inc —Houston, TX
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6d
Claims Customer Service Representative
INNOVATIVE INTEGRATED HEALTH —Fresno, CA
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Medical Support Assistant
Jamison Professional Services Inc —Aurora, CO
- $22.99 an hour
- Full-time
- Remote
- Computer literacy
- HIPAA
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1d

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Prior Authorization Specialist

Koya Medical, Inc. -
Remote

Quick Apply

Job Details

Full-time
$55,000 - $60,000 a year
2 days ago

Qualifications

High school diploma or GED
Salesforce Cloud
Pre-authorization review for utilization management
CRM system proficiency
Healthcare reimbursement methods

Full Job Description

Koya is always looking for curious and passionate individuals who want to join a fast-paced team for a career in transforming venous and lymphatic care through innovative people-centric technologies that improve lives and empower self-care. Koya values integrity, humility, hard-work, camaraderie, and fun. We offer a base + bonus compensation package, and a competitive benefits program.

Job Summary

The Authorizations Specialist ensures timely payer approvals by managing authorizations, precertifications, predeterminations, and referrals to maximize reimbursement for patients and the organization. This role involves educating payers on the Dayspring and applying strong insurance expertise to navigate complex authorization requirements across various health plans.

This role reports to the Manager, Prior Authorization within the Reimbursement Operations Department. The role is full time, exempt and will work remotely.

Essential Duties and Responsibilities

The essential functions include, but are not limited to the following:

Submit medical records and documentation to payers for coverage approval, including network exceptions and single case agreements
Review clinical documentation to determine medical necessity
Process authorizations, precertifications, predeterminations, and referrals across multiple health insurance plans
Educate payers on product features and benefits to support coverage and reimbursement
Communicate payer process findings clearly to internal stakeholders
Collaborate with internal departments to ensure accurate patient order processing
Maintain compliance with HIPAA and all regulatory requirements
Ensure accuracy while meeting productivity and quality standards
Assist in developing internal workflows and best practices
Perform other duties as assigned

Minimum Qualifications

Education, Experience and Training

High school diploma required; Associate’s or Bachelor’s degree preferred
Minimum 3 years of experience in prior authorization and reimbursement processes
Background in medical devices, healthcare reimbursement, or related field

Knowledge, Skills and Abilities

Strong understanding of insurance processes and authorization workflows
Excellent written and verbal communication skills
High attention to detail with strong organizational and multitasking skills
Ability to work independently and collaboratively in a fast-paced environment
Proficient in navigating payer portals and Salesforce
Demonstrated ability to multitask, prioritize, and meet deadlines under pressure

Core Competencies

Communication & cultural competence
Initiative & critical thinking
Flexibility & adaptability
Planning & organization
Teamwork & collaboration

Tools and Technology

Google Suite, Microsoft Office Suite, Adobe, Salesforce CRM

Physical Functions and Work Environment

The physical functions described here are representative of those that must be met by an employee to successfully perform the essential functions of this position. Reasonable accommodations may be made to enable individuals with disabilities to perform the functions.

While performing the duties of this position, the employee is regularly required to talk or hear. The employee frequently is required to use hands or fingers; handle or feel objects, tools, or controls. The employee is occasionally required to stand; walk; sit; and reach with hands and arms. The employee must occasionally lift and/or move up to 25 pounds. Specific vision abilities required by this position include close vision, distance vision, and the ability to adjust focus. The noise level in the work environment is usually low to moderate.

Note

This job description in no way states or implies that these are the only duties to be performed by the employee(s) incumbent in this position. Employees will be required to follow any other job-related instructions and to perform any other job-related duties requested by any Koya manager authorized to provide instruction or assign work. Duties, responsibilities, and activities may change at any time with or without notice.

All duties and responsibilities are essential functions and requirements and are subject to possible modification to reasonably accommodate individuals with disabilities. To perform this job successfully, the incumbents will possess the skills, aptitudes, and abilities to perform each duty proficiently. Some requirements may exclude individuals who pose a direct threat or significant risk to the health or safety of themselves or others. The requirements listed in this document are the minimum levels of knowledge, skills, or abilities. This document does not create an employment contract, implied or otherwise, other than an “at will” relationship.

Koya Medical, Inc. is an Equal Opportunity Employer, drug free workplace, and complies with ADA regulations as applicable.

#LI-REMOTE

The pay range for this role is:
55,000 - 60,000 USD per year(Remote (United States))

Quick Apply

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enable healthcare inc. jobs in remote

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