Davis Companieshttp://daviscos.com/wp-content/themes/davis_theme/assets/images/logo.svg325 Donald J. Lynch Boulevard, Suite 201MarlboroughMA01752USAcustomer support[+800-482-9494][+508-481-8519]
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SR Medical Authorization Specialist

  • Specialty:

    Administrative
    • City:

      Cordova
    • State:

      TN
    • 38016
  • Assignment Type:

    Direct Hire
  • Job Id:

    59797

Description

Are you looking for an opportunity where you can be part of a growing industry? Well regarded company in the Medical Device industry needs a dynamic SR Medical Authorization Specialist to join a growing team in Memphis, TN. This direct hire position offers growth and a great benefit program.

SR Medical Authorization Specialist
Responsibilities:
  • Support the reimbursement team by aggressively pursuing authorization and reimbursement.
  • Demonstrate a consistent performance standard of excellence
  • Review and interprets medical record documentation for patient history, diagnosis, and previous treatment plans
  • Utilizes payer-specific approved criteria to determine medical necessity or clinical appropriateness for the company's products
  • Submit pertinent demographic and supporting clinical documentation with pre-authorization requests timely to avoid unnecessary delays in treatment
  • Maintains and documents complete and accurate billing information
  • Performs on-going check and balance system to ensure the integrity of the patient billing data
  • Operates compliantly at all times
  • Works with the Order Management team to secure any additional information and medical documentation form patient and/or prescribing HCP
  • Assist with order escalations to ensure appropriate payer guidelines have been applied
  • Reviews payer denials; prepares and submits appeals on behalf of patients
  • Complies with all health, safety and environmental policies
  • Completes all required training in a satisfactory and timely manner
Qualifications:
  • College Degree plus 4 years medical authorization experience involving medical record review 
  • Knowledge and interpretation of medical terminology and ICD-10 coding
  • Medical Coding certification required
  • Experience with Medicare claim audit process
  • Reviewing medical records to resolve complex medical necessity questions
  • Strong knowledge of Anatomy and Physiology
  • Good written and oral communications skills
  • Professional persistence, manage detailed information; maintain high level of organization
  • Experience with Microsoft Word, Excel, Outlook and knowledge of SAP or other integrated software applications
DAVIS Companies partners with the top employers locally and nationally. They choose us because of our reputation for finding high quality talent, fast, but also our experience for evaluating and representing the best candidates in the marketplace.  We make every effort to provide updates and feedback to candidates at each stage of the process as we appreciate how stressful looking for a new role can be.  Apply today and experience “The DAVIS Difference”. 

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Quick Apply

  • As an Equal Employment Opportunity Employer, DAVIS has reporting requirements which require us to invite employees to voluntarily self-identify their race/ethnicity. Submission of this information is voluntary and refusal to provided it will not subject you to any adverse treatment. The information obtained will be kept confidential.
  • Accepted file types: pdf, doc, docx, txt, rtf.
  • By applying to this position and providing my contact information, I give The DAVIS Companies permission to provide me with email communications and information.

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