Billing & Prior Authorization Specialist
External
Okgov · Oklahoma CountyPart-timeOn-site2d ago
ComplianceDocumentationProcess Improvement
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Benefits
The salary for this position is up to $60,000.00 based on education and experience.Why you'll love it here!Oh yeah, did we mention perks? We know that benefits matter and that is why we offer a competitive benefits package for all eligible employees.Generous state paid benefit allowance to help cover insurance premiums.A wide choice of insurance plans with no pre-existing condition exclusions or limitations.Flexible spending accounts for health care expenses and/or dependent care.Retirement Savings Plan with a generous match.15 days of vacation and 15 days of sick leave the first year for full time employees.11 paid holidays a year.Student Loan repayment options & tuition reimbursement.Employee discounts with a variety of companies and venders.Longevity Bonus for years of serviceJob DescriptionLocation : Open to the best applicant statewideSalary : up to $60,000.00, based on education and experienceFull Time /Part Time : Full TimeWork Schedule : Monday - FridayPrimary Hours : 8-5Position Description:This position does not supervise staff but provides Subject Matter Expert technical guidance within the Allied Health Service & Pediatric Audiology Programs.Position Responsibilities/Essential Functions:Revenue Cycle ManagementReview, correct, and resubmit denied or rejected claims according to payer requirements.Post and reconcile payment/non-payment information from remittance advice (RA/EOB) in billing systems.Monitor claims through adjudication and resolve billing discrepancies timely.Identify denial trends and implement corrective actions to improve claim outcomes.Verify insurance eligibility, benefits, authorizations, and coverage requirements, including hearing aids and assistive technology.Prior Authorization AdministrationSubmit, track, and follow up on prior authorizations in compliance with payer requirements.Review authorization documentation for accuracy and completeness.Maintain authorization records in EHR and billing systems.Monitor authorization timelines, service limits, and payer requirements to ensure uninterrupted reimbursement.Coordinate with clinical staff on approvals, denials, documentation needs, coverage limitations, and out-of-pocket costs.Collaborate with backup billing staff on authorization processes.Credentialing & Payer MaintenanceSupport provider credentialing and enrollment for Medicaid, Medicare, managed care, and private insurance for AHS programs and Pediatric Audiology.Maintain accurate provider and payer information in billing systems.Assist with payer portal access and documentation updates.Systems Support & Process ImprovementIdentify and resolve system, workflow, and claim processing issues.Coordinate with payers, vendors, clearinghouses, providers, and staff to address insufficienciesSupport referral, order intake, and documentation processes to ensure billing and authorization accuracy.Maintain compliance with payer policy, documentation, and form changes.Recommend and support process improvements to enhance efficiency, accuracy, and compliance.Training & Program SupportDevelop guidance materials and provide staff training/technical assistance.Serve as an authorization resource for program staff and external partners.Respond to inquiries professionally and timely.Maintain confidentiality and comply with regulatory requirements.Regular office presence required.Perform othHealth insurancePaid time offFlexible schedulePerformance bonus
Additional Information
Job Posting Title Billing & Prior Authorization Specialist Agency 340 OKLAHOMA STATE DEPARTMENT OF HEALTH Supervisory Organization 340 Allied Health Job Posting End Date Refer to the date listed at the top of this posting, if available. Continuous if date is blank. Note: Applications will be accepted until 11:59 PM on the day prior to the posting end date above. Estimated Appointment End Date (Continuous if Blank) Full/Part-Time Full time Job Type Regular
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