prior authorization rep (phrn/life sciences Customer Service Representative) + signing bonusOmega Healthcare Management Services Inc.

OMEGA HEALTHCARE MANAGEMENT SERVICES INC.
 
Is currently looking for
 
ACCOUNTS RECEIVABLE EXECUTIVE (PHRN/Life Sciences Customer Service Representative) for a US HEALTHCARE ACCOUNT
 
Qualifications:
Candidates must possess a bachelor's degree:
Graduate of Bachelor of Science in Nursing - PHRN
Life Science - MT, PT & etc.
1-2 years of experience in BPO
Good process and project knowledge
Proficiency in MS office
Logical reasoning, attention to details and analytical skills
Good communication and presentation skills
Job Duties and Responsibilities:
Prioritize incoming authorization and referral requests according to queue urgency
Review patient's clinical and chart documentation related to the service submitted by the provider's office
Obtain and/or follow up on authorization and referral requests from the patient's payer/s through any of the following methods-depending on the payer's policy:
Perform outbound calls to payer's authorization department
Access payer's authorization online portal
Submit faxes to payer's authorization department
Respond to payer's clinical questions to be able to proceed with the authorization and referral requests
Obtain and/or follow up payer's peer-to-peer review requirements and send them back to provider's office for the actual initiation
Cater inbound calls from payers and perform necessary actions required for the task
Listen and review voicemail messages from payers then perform necessary actions required for the task
Required Skills:
Solid understanding of anatomy & physiology, including how body systems function and an understanding of disease processes
Comprehensive understanding of Medical Terminology
Prior experience in processing multispecialty authorizations including contact with payers
Experience in medical coding specially for Cardiac procedures
Experience with general computer software (Internet, Word, Outlook, PDF required)
Proficiency to learn new software programs quickly
Excellent customer service skills: communicates clearly and effectively
Excellent verbal and written communication skills
Professional and effective interaction skills with co-workers, clients, providers, and vendors
Proven ability to work well individually and as a team member
Strong attention to detail
Ability to follow company and account-specific standard operating procedures and policies
Ability to adapt to constantly changing environment
Ability to prioritize and organize multiple tasks by remaining focused and quality-driven at all tasks at hand
Ability to remain organized with multiple interruptions
Ability to make decisions independently without bypassing any company and account-specific standard operating procedures and policies
Ability to comfortably receive constructive feedback
Be part of an offshore provider of healthcare outsourcing services!
Competitive salary package
Health Insurance benefit plus 2 FREE dependents
Rewarding career and opportunities and a lot more!