Review funded cases and verify required information to submit is present and correct
Create prior authorization packet according to payor requirements
Submit prior authorization request according to payer requirements
Save submission packet to electronic record
Document all steps taken to move case forward with authorization process
Follow up on requests submitted to payors
Perform various other tasks as assigned.
Identify and report payor trends.
Assists with other Intake functions as need to meet team goals.
Performs various other tasks as assigned.
Requirements
EDUCATION / EXPERIENCE REQUIREMENTS:
High school diploma
One year experience working in a medical office and familiar with diagnosis codes, prior authorizations, insurance companies OR
One year experience of submitting for prior authorization for medical services.
COMMUNICATION SKILLS:
Consistently demonstrate characteristics in alignment with the Tobii Values
Ability to communicate with department managers and director
COMPUTER OR TECHNICAL SKILLS:
Strong MS Office Word and Outlook skills.
Comfort with using multiple online apps and programs simultaneously.
Familiar with modifying, merging, and splitting PDFs.
OTHER SKILLS REQUIREMENTS:
Knowledge of coordination of benefits of Medicare, Medicaid, and third-party insurance
Detail oriented
Spending up to 90% of working hours on the phone, making outgoing calls
WORK ENVIRONMENT REQUIREMENTS:
Ability to work at a desk for prolonged periods
Able to work with interruptions in a fast-paced environment
Ability to travel to the Pittsburgh office for team activities/ trainings (approx. 4 times per year)
We are able to pay this Prior Authorization Submitter $20/hr.
Apply today!
We believe in empowering individuals - including our own employees - to reach their full potential. So, if you want to change lives while growing your own career, we'd love to hear from you.
Where we stand:
We believe diversity not only enriches our workplace culture, but also gives us a strategic advantage. Working with people from a variety of backgrounds and perspectives helps us all become better communicators, better problem solvers, and better human beings. Our differences make us stronger.
Why join us?
We're on a mission to empower people with disabilities to do what they once did or never thought possible. As the world-leader in assistive communication solutions, we empower our customers to express themselves, connect with the world, and live richer lives .
At Tobii Dynavox, you can grow your career within a dynamic, global company that has a clear, impactful purpose - with the flexibility to also do what truly matters to you outside of work. What's more, you'll be part of a work culture where collaboration is the norm and individuality is welcomed.
As a member of our team, you'll have the power to make it happen. You'll solve challenges, deliver solutions and develop new, efficient processes that make a direct impact on our customers' lives.
JOB SUMMARY:
The Prior Authorization Submitter (PAS) works directly with insurance companies to request a review for medical necessity and prior authorization for durable medical equipment before providing services. The PAS creates a submission packet and submits requests via online portals, faxes, and mail. After submitting for prior authorization, the PAS regularly follows up on the submission for payer decision . All completed steps must be noted in our electronic database of medical records.
The Prior Authorization Submitter must live in Pacific or Mountain time zones.
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