Insurance Prior Authorization Specialist

NPL Home Medical is one of the industry leaders in providing custom wheelchairs in Ohio.  Since 1993, our promise has always been to deliver the highest quality service to both patients and medical professionals while creating a wheelchair solution that addresses our customer’s unique needs.  At NPL, responding to our customer’s needs is always Job #1.

About This Career Opportunity:

We have an exciting opportunity for you to join our team as an insurance Prior Authorization Specialist.  In this position, you will report to the Department Manager.  As a member of our team, you will have an opportunity for personal and professional growth and career advancement as we build on our consecutive years of significant growth.  We are proud to have been selected as one of 2021 Best Employers in Ohio by Crain’s Magazine. This position can work remotely or from our offices in Strongsville.  Do not miss this opportunity to find career success with a forward thinking, entrepreneurial, and growing company.

Summary of Responsibility:

The Insurance Prior Authorization Specialist responsibilities involve a broad range of tasks relating to helping NPL receive prior authorization from the insurance companies for the purchase of a particular wheelchair relating to a particular patient.  This can include a variety of work activities including, but not limited to, filling out the correct paperwork each insurance company requires, submitting those documents to the insurance companies electronically, and running to ground any issues arising to getting the appropriate authorization.

Main responsibilities and duties:

  • Create prescribed packets of insurance documents that will be used as part of the electronic prior authorization submission to the insurance company.
  • Assist with uploading prior authorization packages to insurance companies.
  • As prescribed, check insurance company portals to check the status of prior authorization submissions and notify key stakeholders of the status. Should the insurance company require additional documentation, you would be responsible for collecting that additional information.
  • If denied, follow our defined Pre-Authorization Denied Process including verifying reason for denial and compiling the required paperwork necessary to overturn the denial.
  • Identify trends relating to prior authorization changes at the insurance companies that could require an NPL process change and bringing to the attention of management.

 

Qualifications and Experience:

  • Three (3) years of experience engaging with insurance companies processing claims or preparing insurance packages for submission.
  • Ability to create and manipulate excel spreadsheets
  • Must be able to demonstrate strong organizational and time management skills
  • Evidence of strong attention to detail and accuracy
  • Capable of working independently with little supervision

Working Conditions:

While performing the duties of this Job, the employee is regularly required to stand; sit and talk or hear.  The employee is occasionally required to walk; use hands to finger, handle, or feel; reach with hands and arms; climb or balance; stoop, kneel, crouch, or crawl.  Specific vision abilities required by this job include close vision, distance vision, and color vision.

NPL Home Medical is an Equal Opportunity Employer.  NPL Home Medical does not discriminate against any person on the basis of gender, race, color, national origin, religion, disability, age, veteran status, gender identity or sexual orientation in admission, treatment, or participation in its programs, services and activities, or in employment, or on the basis of gender in its health programs and activities.

Job Type: Full-time

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