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The Authorization Specialist is responsible for obtaining initial and renewal prior authorizations for medical therapies from insurance companies. They collaborate with clinicians to ensure documentation meets formulary guidelines, manage quality reviews, and assist in communication across departments to support authorization requests and enhance productivity.

The Payment Specialist is responsible for accurately processing payments and adjustments, managing refunds for overpayments, identifying payer trends, and ensuring claims are adjusted correctly. The role also includes following up on paper denials and supporting various tasks as assigned by supervisors.

The Insurance Verification Coordinator will manage daily insurance verification functions, update patient information, secure reimbursement paperwork, and assist with case management. The role involves working closely with patients to verify their insurance benefits, generate price quotes, and obtain necessary prior authorizations, while ensuring client satisfaction and supporting case managers in price negotiation and issue resolution.

The Authorization Specialist is responsible for obtaining initial and renewal prior authorizations for therapies from insurance companies and collaborate with clinicians for required medical documentation while managing quality reviews of requests.

The Audit Coordinator is responsible for facilitating the auditing of home infusion claims within the Revenue Cycle process. Duties include conducting quality audits on new employees, performing claim denial audits, assisting in training, and developing Standard Operating Procedures while ensuring compliance with quality standards.

As a Medical Billing Specialist, you will manage escalation requests related to insurance claims, ensuring timely and accurate resolutions. Responsibilities include communication with payors and patients, processing changes and rejections, identifying billing trends, and maintaining quality standards.

The PBM Billing Specialist is responsible for billing and collecting insurance claims, processing patient and insurance changes, and ensuring accurate and timely billing while identifying issues and trends in billing. Communication with patients and payors is essential, along with maintaining records and quality assurance standards.