Address
Form of work
SalaryCANDIDATE MUST BE LOCATED IN MICHIGAN!
JOIN THE MICHIGAN PAIN CONSULTANTS (MPC) FAMILY TODAY! Make a difference in the lives of people suffering from chronic pain by working at Michigan’s longest established pain management practice!
A little about us and why people want to work with us: MPC is a team of highly trained medical professionals specializing in the expert diagnosis and treatment of chronic pain conditions. We’ve been around for almost 40 years and are constantly working to learn, grow and develop. We genuinely care about our employees and their families, as well as our patients, and want you to become part of our family.
Benefits that we offer:
- Competitive wages with annual evaluation
- Paid holidays
- No weekends
- Generous vacation time with carryover
- 401(k) with employer match and additional employer contributions
- Health, dental, vision, basic life/AD&D insurance
- Health Savings Account (HSA), including employer contributions
- Voluntary life/AD&D insurance, short- and long-term disability insurance, and accident & critical insurance
- Additional voluntary benefits including personal excess liability, and legal planning
- Employee Assistance Program
Job Description:
As a prior authorization specialist, you review requests for authorization for specific treatments or procedures. Your duties include reviewing medical records and documents related to the application. You consider each prior authorization request and collect evidence and patient information to support your decision. You communicate with the insurance provider to obtain additional information if needed. Your responsibilities in this position also involve ensuring the authorization meets regulations and requirements and contractual obligations of all parties involved. Your job can also require coordinating with administrators and healthcare providers to gain necessary information and ensure that patients receive authorized care.
What we’re looking for in a team member:
- General knowledge of insurance cards, medical insurance terminology, medical benefits, and CPT and ICD10 coding
- Previous experience with a medical billing company in the account’s resolution, prior authorization, or claim appeals department
- Excellent interpersonal skills
- Attention to accuracy and detail in all aspects of responsibilities
- The ability to manage priorities and focus on completing tasks efficiently and within time frames
- Experience performing research utilizing the Internet
- Excellent organizational skills
- Experience implementing and managing organizational protocols
- Flexibility and a willingness to perform other reasonable duties as requested
What are the responsibilities?
- Verify patients medical plan benefits and requirements according to their specific medical policy, to ensure necessary procedures are covered by an individual’s provider
- Handle incoming and outgoing calls from internal team members, insurance payers, and customers related to insurance benefits
- Determine if prior authorization is required for ordered services
- Ensures appropriate clinical documentation is available and complete before submitting prior authorization
- Send clinical documentation to the insurance company for review and approval
- Follow up with insurance companies to ensure documentation has been received and prior authorization is in process
- Ensure security and confidentiality of data and office technology
- Perform additional daily tasks and/or special projects, as necessary
