Revenue Authorization Specialist

About the role

Responsible for all aspects of the authorization/pre-certification or referral process. Verifies insurance eligibility and contacts the payer to initiate pre-certification by providing supporting medical documentation, follows up with insurance on outcome of determination for all medical procedures and services in attempt to obtain a successful authorization. Specialty: Cardiology and Neurology.

Mount Carmel, a member of Trinity Health, has been a transforming healing presence in Central Ohio for over 135 years. Mount Carmel serves over 1.3 million patients each year at our five hospitals, free-standing emergency centers, outpatient facilities, surgery centers, urgent care centers, primary care and specialty care physician offices, community outreach sites and homes across the region. Mount Carmel College of Nursing offers one of Ohio's largest undergraduate, graduate, and doctor of nursing programs.

Responsibilities

• Assists offices in resolving billing discrepancies and any other referral/authorization issues.
• Contacts insurance companies via appropriate methods and obtains pre-certifications and authorizations.
• Obtains urgent authorizations same day, next day.
• Verifies correct procedural and diagnostic codes and insurance verification.

Requirements

• High school diploma.
• One to three (1‑3) years of experience with insurance referrals, prior authorizations, or equivalent professional revenue cycle knowledge.
• Knowledge of medical terminology and procedures at the level needed to perform responsibilities.

Schedule

Monday – Friday, 9:00 am – 5:30 pm. Remote position.

Benefits

• Mount Carmel Health System recognized by Forbes in 2025 as one of America’s Best State Employers.
• Competitive compensation and benefits packages including medical, dental, and vision with coverage starting on day one.
• Retirement savings account with employer match starting on day one.
• Generous paid time off programs.
• Employee recognition programs.
• Tuition/professional development reimbursement starting on day one.
• RN to BSN tuition 100% paid at Mount Carmel’s College of Nursing.
• Relocation assistance (geographic and position restrictions apply).
• Employee Referral Rewards program.
• Mount Carmel offers DailyPay – if hired as an eligible colleague, you’ll be able to see how much you’ve made every day and transfer your money any time before payday.
• Opportunity to join Diversity, Equity, and Inclusion Colleague Resource Groups.