Medical Necessity Specialist

Medical Billing and CodingMedical Billing and CodingFull TimeRemoteTeam 10,001

Location

United States

Posted

14 days ago

Salary

$65K - $75K / year

No structured requirement data.

Job Description

This description is a summary of our understanding of the job description. Click on 'Apply' button to find out more.

Role Description

We are looking for an assertive and driven clinical professional to join our team in a crucial administrative role to help our ABA Therapy organization grow!

  • Support the Vice President of Clinical Services, the Director of Clinical Advocacy and Authorizations, and the Regional Autism Advocate(s) with time-sensitive documentation fidelity.
  • Discuss clinical needs with insurance companies.
  • Ideal candidates will be a Registered Behavior Technician (RBT) with experience in the field or an RBT completing their Master’s Program to become a Board Certified Behavior Analyst (BCBA).

Qualifications

  • Registered Behavior Technician (RBT) required; An RBT with 2+ years of clinical experience is preferred.
  • Undergraduate degree is ideal but not required.

Requirements

  • Familiarity with SalesForce is recommended but not required.
  • Working knowledge and understanding of Applied Behavior Analysis (ABA) therapy is strongly recommended.
  • Previous experience negotiating with insurance companies.
  • A strong, pleasant personality with a high EQ.
  • Extremely detail oriented – you minimize mistakes because you care about how your work affects patients.
  • Assertive and strong communication style - you know how to get what you want because you can eloquently present the facts and advocate for patient services.
  • You possess a high-level of organizational skills - you rarely drop the ball because you love having systems in place to keep things running smoothly.
  • You like to work really hard – you aren’t watching the clock for quittin’ time because there is always more than needs to be done, and you like that.

Responsibilities

  • Assisting Regional Autism Advocate(s) in campaigning to insurance companies on patient services.
  • Review and confirm patient intake paperwork.
  • Review & proof read patient reports provided by BCBAs and prepare patient documents for insurance authorization requirements.
  • Manage & upkeep patient paperwork in SalesForce.
  • Participate in meetings with the Corporate Team.
  • Maintain patient communication with the Office Managers across all ABC locations.
  • Assist Regional Autism Advocate(s) and Director of Clinical Advocacy and Authorizations with Ad Hoc projects.
  • Oversee and maintain the company's healthcare data entry procedures within HIPAA compliance guidelines.
  • Confirm authorization via phone calls, and enter authorization documents quickly and accurately.
  • Confirm, maintain and enter patient's healthcare and authorization information with sensitivity and discretion into the EMR/billing system.
  • Fax and submit for authorization of treatment.
  • Schedule Peer-to-Peer (P2P) calls for insurance companies.
  • Account for submission and resubmission to new insurance companies with updated paperwork.

Benefits

  • 10 Days of PTO, 10 Paid Holidays, 2 Flex Days + More with Tenure.
  • Student Loan Repayment Employer Contributions.
  • Maternity/Paternity Award of up to $3,000 & FSA Options for Childcare.
  • Door Dash Pass and Regional Night of Honors.
  • Up to $600 Student Loan Repayment Options & Tuition Discounts.
  • Professional development opportunities.
  • Leadership opportunities to learn more and take on more responsibilities.
  • 401K Retirement Plans with company matching.

Job Requirements

  • Registered Behavior Technician (RBT) required; An RBT with 2+ years of clinical experience is preferred.
  • Undergraduate degree is ideal but not required.
  • Familiarity with SalesForce is recommended but not required.
  • Working knowledge and understanding of Applied Behavior Analysis (ABA) therapy is strongly recommended.
  • Previous experience negotiating with insurance companies.
  • A strong, pleasant personality with a high EQ.
  • Extremely detail oriented – you minimize mistakes because you care about how your work affects patients.
  • Assertive and strong communication style - you know how to get what you want because you can eloquently present the facts and advocate for patient services.
  • You possess a high-level of organizational skills - you rarely drop the ball because you love having systems in place to keep things running smoothly.
  • You like to work really hard – you aren’t watching the clock for quittin’ time because there is always more than needs to be done, and you like that.

Benefits

  • 10 Days of PTO, 10 Paid Holidays, 2 Flex Days + More with Tenure.
  • Student Loan Repayment Employer Contributions.
  • Maternity/Paternity Award of up to $3,000 & FSA Options for Childcare.
  • Door Dash Pass and Regional Night of Honors.
  • Up to $600 Student Loan Repayment Options & Tuition Discounts.
  • Professional development opportunities.
  • Leadership opportunities to learn more and take on more responsibilities.
  • 401K Retirement Plans with company matching.

Related Categories

Related Job Pages

More Medical Billing and Coding Jobs

Risk Coder

Community Care Cooperative

Community Care Cooperative (C3) is a 501(c)(3) non-profit, Accountable Care Organization (ACO) governed by Federally Quality Health Centers (FQHCs). Our mission is to leverage the collective strengths of FQHCs to improve the health and wellness of the people we serve. We are a fast-growing organization founded in 2016 with 9 health centers and now serving hundreds of thousands of beneficiaries who receive primary care at health centers and independent practices across Massachusetts. We are an innovative organization developing new partnerships and programs to improve the health of members and communities, and to strengthen our health center partners.

Medical Billing and Coding14 days ago
Full TimeRemote

The Certified Risk Coder will be a part of an emerging coding team and coding service that performs retrospective and prospective risk coding reviews and completes provider training for a group of outpatient primary care practices across Massachusetts. This work ultimately leads ...

United States

Pro Fee Coder – General Pediatrics

Savista

An end-to-end revenue cycle services provider serving healthcare organizations for over 30 years.

Medical Billing and Coding14 days ago
Full TimeRemoteTeam 1,001-5,000Since 1994H1B No Sponsor

Pro Fee Coder reviewing clinical documentation for healthcare billing

United States
$22 - $34 / hour
Medical Billing and Coding14 days ago
Full TimeRemoteTeam 10,001+Since 1915H1B Sponsor

Senior Coder translating medical records into coded form at Geisinger

Pennsylvania

Medical Coder

Geisinger

Better health, easier.

Medical Billing and Coding14 days ago
Full TimeRemoteTeam 10,001+Since 1915H1B Sponsor

Coder II specializing in health information coding and reimbursement processes

Pennsylvania