CMN & Reauthorization Specialist

Job Type

Full-time

Description

PromptCare is seeking a highly motivated and detail oriented CMN and Re-Authorization Specialist to join our team in the respiratory industry. The ideal candidate will have experience in the healthcare industry, specifically in respiratory therapy, and be able to work in a fast-paced environment. The position will entail the creation, submission, follow up and logging of recertification CMN's to physician offices via Brightree; as well as the timely submission of authorization requests to assigned payers. If you are a motivated individual with a passion for providing excellent patient care and have experience in CMN and re-authorization requests for infusion therapy, we encourage you to apply for this exciting opportunity. To learn more about our company, visit us at PromptCare In-home Respiratory and Infusion

Reports to: Departmental Lead, Supervisor or Manager

Job Type: This is a full-time position, 40 hours per week, Mon-Fri 8:30am-5pm

Job Location: hybrid out of Concord, NC, open to remote

Requirements

• High School Diploma or equivalent
• Ability to handle multiple tasks in fast paced, challenging environment
• DME background is a preferred
• Medical Reimbursement background is preferred
• Appropriate computer skills for the position (Microsoft Office Suite) and areas of influence
• Brightree experience is preferred
• Clinical, medical office administrative, or related experience preferred

• Work collaboratively with other department staff such as AR Specialists to ensure timely collections or resolution of issue
• Perform Brightree related transactions such as the creation, submission and logging of a CMN accurately and timely
• Ensure that proper CMN/prescription documentation is on file in a timely manner to ensure compliance for equipment and supplies billed to commercial, state and federal entities
• Submission of authorization requests will be completed using paper forms, printed documentation, fax, payer portals or other means
• Contact patients, physician offices and referral sources as needed regarding account issues
• Escalate problem accounts and ensure resolution
• Submit in a timely manner, the required forms and documentation to obtain authorization for services, supplies and equipment for patients under the assigned payers
• Understand payer requirements to ensure authorization approval is granted
• Regular contact with patients, insurance plans, physician offices, respiratory therapists and other personnel is necessary to ensure timely turnaround and approval
• Other duties as assigned

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. While performing the duties of this job, the employee is regularly required to talk and listen, open filing cabinets and bend or stand as necessary. This position requires the ability to occasionally lift office products and supplies of 20 pounds but no more than 35 pounds.

• Competitive Salary
• Medical, Dental, Vision Package
• 401(k) plan (discretionary)
• PTO - Vacation, Sick and Personal days, and paid holidays
• Referral bonuses & Discount Ticket Program
• Lunch & Learn Programs
• Employee Recognition Program

The PromptCare Companies is committed to Equal Employment Opportunity (EEO) and prohibits employment discrimination on the basis of race, color, age, national origin, religion, gender, gender identity, sexual orientation, pregnancy, marital status, genetic disposition, disability, veteran's status or any other characteristic or classification protected by State/Federal/Local laws. We foster a work environment in which diversity and inclusion are embraced, people are hired and advanced on their merits, and employees are treated with mutual respect and dignity.