Remote Prior Authorization Rn Jobs in Charleston, WV

Location:

Pay Range:

Position Summary: The Revenue Representative is responsible for applying fundamental knowledge of healthcare revenue cycle practices and procedures as it relates to posting, reconciling, researching, analyzing and resolving insurance claims and patient balances. The Revenue Representative provides support to the Revenue Manager for the day-to-day financial operations of the pharmacy.

1. Education: High School Diploma or equivalent required.
2. Previous Experience:
Minimum of one (1) year experience in Pharmacy/Medical accounts receivable and collections or comparable experience is required. Two (2) or more years is preferred.
At least one (1) year of prior work experience in the medical field with experience in benefits verification and medical billing preferred.
3. Core Capabilities:
Analysis & Critical Thinking: Critical thinking skills including solid problem solving, analysis, decision-making, planning, time management and organizational skills. Must be detailed oriented with the ability to exercise independent judgment.
Interpersonal Effectiveness: Developed interpersonal skills, emotional intelligence, diplomacy, tact, conflict management, delegation skills, and diversity awareness. Ability to work effectively with sensitive and confidential material and sometimes emotionally charged matters.
Communication Skills: Effective communication skills (oral, written, presentation), is an active listener, and effectively provides balanced feedback.
Customer Service & Organizational Awareness: Strong customer focus. Ability to build an engaging culture of quality, performance effectiveness and operational excellence through best practices, strong business and political acumen, collaboration and partnerships, as well as a positive employee, physician and community relations.
Self-Management: Effectively manages own time, conflicting priorities, self, stress, and professional development. Self-motivated and self-starter with ability work independently with limited supervision. Ability to work remotely effectively as required.
Must be able to work effectively in a fast-paced, multi-site environment with demonstrated ability to juggle competing priorities and demands from a variety of stakeholders and sites.
Computer Skills:
Proficiency in MS Office Word, Excel, Power Point, and Outlook required.
Proficiency in CPR+ (Complete Patient Records) and ORCA software preferred.
Working knowledge of ONCO EMR (Electronic Medical Records) preferred.
4. Certifications/Licenses:
Active Registered Pharmacy Technician license in state of residence and Pharmacy Technician certification (PTCB) is preferred.
5. Travel (double click to check relevant box): 0%
Remote: No
Standard Work Days/Hours: Monday to Friday 8:00 AM - 5:00 PM. Saturday 9:00AM - 1:00PM as required for business needs.

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