Cvs Prior Authorization Remote Jobs in Hawaii (NOW HIRING)

Description

Why work at nimble?

This is a great opportunity to join a well-established and market-leading brand serving a high-growth end market while gaining valuable experience working closely with Executive leadership. As an organization, we are in high-growth mode through acquisition, with a laser focus on building a positive culture.  

Who we are!

nimble solutions is a leading provider of revenue cycle management solutions for ambulatory surgery centers (ASCs), surgical clinics, surgical hospitals, and anesthesia groups. Our tech-enabled solutions allow surgical organizations to streamline their revenue cycle processes, reduce administrative burden, and improve financial outcomes. Join more than 1,100 surgical organizations that trust nimble solutions and its advisors to bring deep insights and actionable intelligence to maximize their revenue cycle.

We provide services in nearly every US state and our team of experts works around the globe managing over $10 billion in net revenue as we continue to build and innovate a world class organization with people like you. 

Together, we embrace challenges, fuel innovation, and strive to exceed expectations. Healthcare means a lot more to us, we care about creating an environment where our coworkers, clients, and communities' social, financial, and physical health is at the forefront of everything we do.
 

What you'll be doing!

• Calculate and provide accurate, timely cost estimates for scheduled procedures based on patient insurance, benefits, and historical data
• Verify insurance eligibility, benefits, and coverage levels (Medicare, Medicaid, Commercial) to determine patient financial responsibility
• Review and provide accurate, timely prior authorization submission for scheduled procedures based on patient insurance, benefits, and clinical data
• Communicate directly with patients regarding their estimated financial liability and discuss payment options or financial counseling needs
• Secure necessary pre-certifications and authorizations, ensuring all documentation is accurate
• Log in and out of multiple systems (including practice management systems) to research and answer patient's questions, accurately and with detail
• When handling incoming, returning or placing outbound calls, adhere to HIPAA privacy regulations 
• Obtain patient payment information over the phone, process the payment and appropriately note the account
• Escalate issues effectively to a supervisor or management for assistance
• Responsible for ensuring all client specific protocols are followed during the patient billing cycles
• Respond to requests, professionally and promptly, and follow up with outstanding requests in a similar matter

Requirements

Who you are!

• High School Diploma or equivalent
• Exceptional customer service skill set
• Mandatory compliance with strict patient confidentiality policies
• Detail oriented
• Basic computer knowledge, with Excel experience
• Strong organizational & time management skills
• Good written and oral communication skills

Logistics:

• This is a remote role supporting a client in Honolulu, HI and will be required to work Hawaii-Aleutian Time Zone hours
• 8-hour shift, Hawaii-Aleutian Time Zone
• Monday - Friday

Benefits:

• Medical, Dental, Vision 
• 3 Weeks PTO + 9 Company Paid Holidays (includes day after Thanksgiving and Christmas Eve)
• 401K Match