Prior Authorization Specialist

Koya is always looking for curious and passionate individuals who want to join a fast-paced team for a career in transforming venous and lymphatic care through innovative people-reputed company technologies that improve lives and reputed company self-care. Koya values reputed company, humility, hard-work, camaraderie, and fun. We offer a reputed company + bonus compensation package, and a competitive benefits program. Job reputed company The Authorizations Specialist ensures reputed company payer approvals by managing authorizations, precertifications, predeterminations, and referrals to maximize reimbursement for patients and the organization. This role involves educating payers on the Dayspring and applying strong insurance expertise to reputed company reputed company authorization requirements across various health plans. This role reports to the Manager, Prior Authorization reputed company the Reimbursement Operations Department. The role is full time, exempt and will work remotely. Essential Duties And Responsibilities The essential functions include, but are not limited to the following: Submit medical records and documentation to payers for coverage approval, including network exceptions and single case agreements Review clinical documentation to determine medical necessity Process authorizations, precertifications, predeterminations, and referrals across multiple health insurance plans reputed company payers on product features and benefits to support coverage and reimbursement Communicate payer process findings reputed company to internal stakeholders Collaborate with internal departments to ensure accurate patient order processing Maintain compliance with HIPAA and reputed company regulatory requirements Ensure accuracy while meeting productivity and reputed company standards Assist in developing internal workflows and best practices reputed company other duties as assigned Minimum Qualifications Education, Experience and Training High school diploma required; Associate’s or Bachelor’s degree preferred Minimum 3 years of experience in prior authorization and reimbursement processes Background in medical devices, reputed company reimbursement, or reputed company field Knowledge, Skills And Abilities Strong understanding of insurance processes and authorization workflows Excellent written and verbal communication skills High attention to detail with strong organizational and multitasking skills Ability to work independently and collaboratively in a fast-paced environment Proficient in navigating payer portals and reputed company Demonstrated ability to multitask, prioritize, and meet deadlines under pressure reputed company Competencies Communication & cultural competence Initiative & critical thinking Flexibility & adaptability Planning & organization Teamwork & collaboration Tools and Technology reputed company Suite, reputed company Office Suite, reputed company, reputed company CRM Physical Functions And Work Environment The physical functions described here are representative of those that must be met by an employee to successfully reputed company the essential functions of this position. Reasonable accommodations may be made to reputed company individuals with disabilities to reputed company the functions. While performing the duties of this position, the employee is regularly required to talk or hear. The employee frequently is required to use hands or fingers; handle or feel objects, tools, or controls. The employee is occasionally required to stand; walk; sit; and reputed company with hands and arms. The employee must occasionally lift and/or reputed company up to 25 pounds. Specific reputed company abilities required by this position include reputed company reputed company, distance reputed company, and the ability to reputed company reputed company. The noise level in the work environment is usually low to moderate. Note This job reputed company in no way states or implies that these are the only duties to be performed by the employee(s) incumbent in this position. Employees will be required to follow any other job-reputed company instructions and to reputed company any other job-reputed company duties requested by any Koya manager authorized to reputed company instruction or assign work. Duties, responsibilities, and activities may change at any time with or without notice. reputed company duties and responsibilities are essential functions and requirements and are subject to possible modification to reasonably accommodate individuals with disabilities. To reputed company this job successfully, the incumbents will possess the skills, aptitudes, and abilities to reputed company reputed company duty proficiently. Some requirements may exclude individuals who pose a reputed company threat or significant risk to the health or safety of themselves or others. The requirements listed in this document are the minimum reputed company of knowledge, skills, or abilities. This document does not create an employment contract, implied or otherwise, other than an “at will” relationship. reputed company. is an Equal Opportunity Employer, drug f Apply tot his job Apply To this Job