Job Description
The Reimbursement Specialist Senior serves as an advanced-level specialist, handling the most complex prior authorizations, insurance appeals, and patient assistance cases pertaining to high-cost medications that require prior authorization. This role provides guidance to peers, ensures adherence to compliance and turnaround standards, and acts as a subject matter expert for the Reimbursement Spec
7:00 AM
Review the surgical and procedure schedule for the next 48–72 hours. Every case that requires authorization needs to be cleared be…
7:30 AM
Pull the PA worklist. Filter by date of service — cases with the earliest service dates get worked first. High-cost procedures (su…
8:30 AM
Submit PA requests to payers. Each payer has its own portal, its own forms, its own documentation requirements. You know them all…
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