Top 57 Prior authorization specialist Jobs in South Carolina

Funding Specialist II - North Region
National Seating & Mobility, Inc. —North, SC
- Microsoft Outlook
- Mid-level
- Office
- Disability insurance
- 401(k)
Quick Apply
Prior Authorization Specialist
Affinity Health Center —Rock Hill, SC
- $16 - $20 an hour
- Full-time
- Organizational skills
- Entry level
- Time management
- Paid training
- 403(b) matching
Automotive Customer Support Specialist
Concentrix —South Carolina
- $23 an hour
- Urgently hiring
- Hybrid work
- 18 years or older
- Computer literacy
- Writing skills
- Paid holidays
- Health insurance
12d
Referral Specialist F/T Day
Prisma Health —Greer, SC
- Full-time
- Psychiatry
- HIPAA
- Mid-level
4d
Prior Authorization Specialist
AO Multispecialty Clinic —North Augusta, SC
- Full-time
- Surgery
- Mid-level
- Clinic
- Health insurance
- Paid time off
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Pre Certification Specialist
MountainView Medical Imaging —Seneca, SC
- $18 - $20 an hour
- Full-time
- Computer literacy
- Basic math
- High school diploma or GED
- Paid holidays
- Health insurance
Quick Apply
Referral Specialist, Urology, FT, Days
Prisma Health —Columbia, SC
- Full-time
- HIPAA
- Mid-level
- High school diploma or GED
8d
Clinical Support Specialist - Referrals
Affinity Health Center —Rock Hill, SC
- $17 - $21 an hour
- Full-time
- Spanish
- Medical office experience
- English
- 403(b) matching
- Paid holidays
10d
Referral Specialist
Health Care Partners of South Carolina —Conway, SC
- $18 - $20 an hour
- Full-time
- Customer service
- BLS Certification
- HIPAA
- 403(b) matching
- Health savings account
Quick Apply
14d
Referral Specialist, Family Medicine, FT, Days
Prisma Health —Columbia, SC
- Full-time
- HIPAA
- Mid-level
- High school diploma or GED
8d
Medical Support Assistant (Advanced)
US Veterans Health Administration —Columbia, SC
- $49,711 - $64,623 a year
- Online Application
- Background check
- Writing skills
- Pass drug screening
- Paid parental leave
- Paid holidays
6d
Patient Access Specialist - Every other weekend/ 3rd Shift 10:30pm - 7am
Prisma Health —Seneca, SC
- Rotating weekends
- Hospital
- Customer service
- Word processing
Patient Access Specialist - CFM Oconee, FT, Days
Prisma Health —Seneca, SC
- Full-time
- Hospital
- Customer service
- Word processing
Patient Access Specialist, Fulltime, OP Registration - Weekends Required
Prisma Health —Seneca, SC
- Weekends as needed
- Customer service
- Word processing
- Computer literacy
8d
Patient Access Specialist, PRN, Nights, Every other Fri and Sat
Prisma Health —Columbia, SC
- Night shift
- Customer service
- Word processing
- Computer literacy
7h
Patient Access Specialist, PT, Nights
Prisma Health —Greer, SC
- Part-time
- Hospital
- Customer service
- Word processing
7h
Patient Access Specialist Part -Time 3rd Shift (every other Friday and Saturday and 1 day a week)
Prisma Health —Seneca, SC
- Part-time
- Hospital
- Customer service
- Word processing
Prior Authorization Coordinator
Carolina Health Specialists —Myrtle Beach, SC
- Temporary
- Customer service
- Writing skills
- Mid-level
Quick Apply
1d
Patient Access Specialist, FT, Evenings, 2:51p-11:09p, Weekends and Hoildays
Prisma Health —Columbia, SC
- Weekends as needed
- Hospital
- Customer service
- Word processing
Customer Service Representative
QUIPT HOME MEDICAL INC —N Charleston, SC
- Microsoft Excel
- High school diploma or GED
- Typing
- Paid holidays
- Disability insurance
Quick Apply

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Funding Specialist II - North Region

National Seating & Mobility, Inc. -
North, SC

Quick Apply

Job Details

Benefits

Disability insurance
401(k)
Tuition reimbursement

Qualifications

Microsoft Outlook
Spreadsheets
High school diploma or GED

Full Job Description

Statement of the Position:

Coordinates with the Funding Manager, Funding Supervisor, Branch Manager, Rehabilitation Technology Supplier (RTS), and other office support personnel to ensure all operational procedures are completed in accordance with company policy and within expected time frames. Responsible for the complete funding transaction cycle including Coding & Pricing, gathering information and documents pertinent to the funding package, ensuring that all documentation is in place, submission to the funding sources and collecting payer decisions including authorizations, denials, and deferrals.

Company Description:

At all levels, working at National Seating & Mobility provides the opportunity to directly impact our client’s lives by giving them self-reliance and independence. Our teams are comprised of passionate individuals, dedicated to providing the best care to each client. We focus on abilities by leveraging technology and creating mobility solutions that are as unique as our client’s needs.

Working at National Seating & Mobility is an opportunity to build a meaningful career, while leaving a lasting impact on the lives of those we serve. Located in more than 40 states, we strive for diversity and offer an array of benefits including 401k, company paid Long Term Disability, and tuition reimbursement.

Duties and Responsibilities / Essential Functions:

1. Manages transaction cycle time (TCT) from Ready to Process to Final Funding Approval, making certain that all necessary steps are taken in the appropriate order ensuring timeliness of process and quality of funding approval.

2. Obtains any required missing demographics and ensures that all client information (Minimum Documentation Requirement) is correct and is put into the work order.

3. Verifies client benefits and coverage and communicates benefit information to client.

4. Gathers and reviews documentation for funding package, including but not limited to: proper prescriptions, Letters of Medical Necessity (LMN), RTS evaluation information, price lists, forms (AOB, ABN, rent or purchase letter).

5. Communicates regularly with Physicians, Therapists, RTSs, and Clients in an effort to secure documentation as required by payer.

6. Communicates changes and escalations in the process and collects needed information from branch personnel, Referral sources, Physicians, Therapists, RTSs, and Clients.

7. Investigates and updates any payer requirements in the UPD.

8. Maintains communication with client throughout the process when applicable, including notifying them of financial responsibility.

9. Follows up with payer sources in order to obtain timely authorization, by properly working the Funding Work Queue.

10. Requests and obtains proper approval for work order credit exceptions.

11. Conducts pre-purchase quality assurance to ensure all approvals and requirements are met prior to purchase of equipment.

12. Conducts pre-delivery verification to ensure all approvals and requirements are met prior to delivery of equipment.

13. Coordinates with other funding areas and responsible for completing all tasks in the Action Required queue.

14. Performs any related job duties assigned by the Funding Manager or Funding Supervisor. Carries out all position expectations in a professional manner and with minimal supervision.

15. Responsible to complete all continuing education requirements to include assigned NSM University courses.

16. Must maintain regular and predictable attendance.

Work Environment:

This job operates in a professional office environment. This role routinely uses standard office equipment such as computers, phones, printers, photocopiers, filing cabinets and fax machines.

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. While performing the duties of this job, the employee is regularly required to talk and hear. The employee is regularly required to sit; use hands repetitively to operate standard office equipment. The employee is frequently required to reach with hands and arms.

Required Education, Experience, & Competencies:

2 years’ experience in Complex Rehab Technology, Medical Billing, or Funding preferred
High school diploma or G.E.D.
Proficient in Microsoft Excel, Word, and Outlook

This job description in no way states or implies that these are the only duties to be performed by this employee. He/She will be required to follow any other instructions and to perform any other duties requested by his/her supervisor.

Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities
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

prior authorization specialist jobs in south carolina

Funding Specialist II - North Region

Prior Authorization Specialist

Automotive Customer Support Specialist

Referral Specialist F/T Day

Prior Authorization Specialist

Pre Certification Specialist

Referral Specialist, Urology, FT, Days

Clinical Support Specialist - Referrals

Referral Specialist

Referral Specialist, Family Medicine, FT, Days

Medical Support Assistant (Advanced)

Patient Access Specialist - Every other weekend/ 3rd Shift 10:30pm - 7am

Patient Access Specialist - CFM Oconee, FT, Days

Patient Access Specialist, Fulltime, OP Registration - Weekends Required

Patient Access Specialist, PRN, Nights, Every other Fri and Sat

Patient Access Specialist, PT, Nights

Patient Access Specialist Part -Time 3rd Shift (every other Friday and Saturday and 1 day a week)

Prior Authorization Coordinator

Patient Access Specialist, FT, Evenings, 2:51p-11:09p, Weekends and Hoildays

Customer Service Representative

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