Eligibility & Prior Authorization Specialist

Eligibility and Prior Authorization Specialist will be responsible for building and maintaining collaborative and productive relationships with internal and external stakeholders relating to eligibility and prior authorization, managing revenue cycle projects, driving performance in operations related to reimbursement and providing direction and oversight of processes impacting cash collections. The specialist will serve as a source of knowledge for the revenue cycle function, performing analysis, identifying trends and prioritizing initiatives for performance improvement. They will develop workflows, track progress, and establish relationships with other departments impacting revenue cycle performance. The specialist will work closely with vendor operations teams to oversee operations activity, track outcomes of payment resolution, and lead meetings to review key metrics. By continually reviewing eligibility changes, they interpret guidance from various sources to determine departmental actions and coordinate with Management to ensure a thorough understanding of issues affecting revenue cycle performance. Develop goals and metrics to link department and revenue cycle initiatives with the organization's strategy. Continuously seeks new and creative technologies that help identify and guide improvement opportunities that align with overall company success.