Prior Authorization Specialist (Remote after training)
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DeCoach Rehabilition Center
Cincinnati, OH, US
Summary
The specialist is responsible for verifying patient insurance eligibility and submitting prior authorization requests to providers. They must also track pending cases, resolve denials, and ensure clinical documentation meets insurance coverage requirements.
Job Description
DeCoach Recovery is a leading addiction treatment center dedicated to providing compassionate care and effective solutions for individuals battling addiction. We take the time with every client to understand their needs and where they are on their recovery journey to help them not only reach sobriety, but to stay sober long-term.
We are currently hiring for a prior authorization specialist to work at our Sharonville Headquarters. You will be responsible for obtaining necessary approvals from insurance providers prior to patients starting treatment or medications. You will review clinical documentation, submit authorization requests, and communicate with healthcare providers and payers to ensure coverage requirements are met. The role includes tracking requests, resolving issues and denials. This position can become remote once training is completed.
Minimum Qualifications:
- High school diploma or equivalent; associate or bachelor’s degree preferred.
- Minimum of 2 years experience in prior authorizations or in a revenue cycle role
- Excellent communication and negotiation skills.
- Proficiency with technology including Microsoft Office Suite
Responsibilities:
-
Verify patient eligibility and coverage limits
-
Review medical charts to ensure clinical notes match what insurance requires
-
Send requests for prior approval to insurance providers
-
Track pending cases and follow up with insurance agents
Benefits:
- Medical, Dental and Vision Benefits
- Yearly Merit Raises
- A Company Matched 401(k) plan
- Tuition Reimbursement
- STAR Eligible Facilities to Assist with Student Loan Forgiveness
- PTO and Paid Holidays
- Opportunities for Advancement
At DeCoach Recovery Centre, we don’t believe in one-size-fits-all solutions. Since opening our doors, our mission has been clear: to provide individualized, comprehensive addiction treatment and give you choice in your recovery. Because every recovery journey is as unique as you.
Founded
2016
Company size
201-500 employees
Industry
Medical Practices
Org type
Partnership
Headquarters
Cincinnati, Ohio
At DeCoach Recovery Centre, we don’t believe in one-size-fits-all solutions. Since opening our doors, our mission has been clear: to provide individualized, comprehensive addiction treatment and give you choice in your recovery. Because every recovery journey is as unique as you.
Founded
2016
Company size
201-500 employees
Industry
Medical Practices
Org type
Partnership
Headquarters
Cincinnati, Ohio