Prior Authorization Specialist

At MSC, we are dedicated to enhancing patient comfort and quality of life with over 75 years of experience and accredited by the Accreditation Commission for Health Care (ACHC).

MSC is a 13 -Time recipient of the prestigious NorthCoast 99 Award as a Top Workplace to work!

MSC is a two-time recipient of the prestigious National HME Excellence Award for Best Home Medical Equipment company in the US.

In addition, MSC is very proud to announce its debut on the Inc. 5000 list in 2024, marking a significant milestone in our company's growth and success!

Join Our Team!

We are excited to announce that we are hiring for a full-time hybrid position. Work in our office location on Tuesdays, Wednesdays, and Thursdays, and enjoy the flexibility of remote work on other days. Benefits included!

Apply today to become a part of our dynamic team!

• Competitive Pay
• Advancement Opportunities
• Medical, Dental & Vision Insurance
• HSA Account w/Company Contribution
• Pet Insurance
• Company provided Life and AD&D insurance
• Short-Term and Long-Term Disability
• Tuition Reimbursement Program
• Employee Assistance Program (EAP)
• Employee Referral Bonus Program
• Social Recognition Program
• Employee Engagement Opportunities
• CALM App
• 401k (with a matching program) / Roth IRA
• Company Discounts
• Payactiv/On-Demand Pay
• Paid vacation, Sick Days, YOU (Mental Health) Days and Holidays

General: As part of the PAR team, participates in monitoring and improving processes relative to the quality, appropriateness, and timeliness of the reimbursement information requirements of our order processing activities.

Responsibilities and Duties:

• Initiates renewal authorization requests with insurance companies and government payers.
• Monitors outstanding renewal authorization requests and initiates follow up of authorizations in a timely manner.
• Responsible for working all outstanding held revenue related to prior authorizations for insurances assigned.
• Handles all claim denials due to missing prior authorization for insurances assigned.
• Maintains accurate and complete records concerning billing activity.
• Manages phone calls related to prior authorizations.
• Training related to PAR processes
• Processes insurance changes when prior authorizations are needed.
• Communicates obstacles or challenges to PAR Supervisor/Manager that may lead to inaccurate or untimely resubmissions of claims.
• Serves as back up for prior authorization team tier 1.
• Other duties as assigned.

Qualifications:
Education: Graduate of an accredited high school or GED equivalence.

Experience/Knowledge/Skills/Physical Requirements:

• Minimum 3 years of revenue cycle experience in healthcare
• Ability to multi-task in a fast-paced environment
• Detail and team oriented
• Effective communication (verbal and written) and organizational skills
• Proven computer proficiency, the use of multiple applications simultaneously
• Previous experience in prior authorizations and insurance verification is required
• Knowledge of the HME/DME industry is preferred