Kestra Medical Technologies, Inc. · 1 day ago
Prior Authorization Specialist
United States
Full-time
Onsite
Entry Level
$57K/yr - $69K/yr
2+ years expKestra Medical Technologies, Inc. is a company focused on innovative cardiac medical device solutions. They are seeking a Durable Medical Equipment (DME) Prior Authorization Specialist to handle the intake and processing of prescriptions and patient information, ensuring efficient communication with patients and healthcare providers regarding prior authorizations.
Health CareHealth DiagnosticsMedical Device
No H1B
Responsibilities
Coordinate with sales representatives, physician's office, and applicable internal/external personnel in regard to medical records and information needed to obtain pre-authorization and benefits upon intake of new patient referrals. Confirm medical records meet medical necessity based on applicable insurance guidelines. Promptly follow-up on patient referrals, physician prescriptions and/or physician work orders
Verify eligibility and benefits of patient health insurance specific to Durable Medical Equipment (DME) by contacting insurance companies by phone, accessing insurance website portals, and utilizing Kestra's medical billing software. Responsible for verification of active coverage, deductibles, accumulations, coinsurance, and pre-authorization requirements
Initiate, track, and complete pre-authorizations requests, including notifying applicable parties of the determination. Assist with appeals for Prior Authorization denials
Upon authorization, place orders for Durable Medical Equipment, notify, and dispatch patient product fitters
Review information and/or reports to confirm scheduled fitters arrive at destination in a timely manner
Review "Delivery Tickets" to confirm they were completed accurately and signed
Perform data entry into medical billing software and other software (Salesforce) including patient demographics, prescribing physician's information, insurance payor information, HCPCS procedure codes, ICD-10 diagnosis codes, etc
Regularly contact and communicate with Team Members, insurance companies, vendors, sales representatives, doctor's offices, practitioners, clearinghouses, billers, and other applicable companies and associates. Send updates on prior authorizations, claims, patient benefits, orders, and other information as appropriate
Regularly communicate with patients to discuss their insurance benefits, out-of-pocket costs, and product payment arrangements
Escalate issues within insurance carriers when not able to obtain reasonable information
Answer incoming phone calls to office and route messages accordingly
Routinely export/import data from one software to another software
Create forms through auto-populating data into custom fields
Perform detailed notetaking with high accuracy on pertinent information
Utilize Adobe Acrobat Pro to create and edit PDF files: insert/move/delete pages; edit/add/redact text; save meta data, create templates, export/import data through plugin, etc
Consistently follow up with patients to confirm patient satisfaction
Accurately complete forms/applications and send out to applicable destination
Exercise patience and empathy when communicating with patients and customers
Be aware of and adapt to changes in medical regulations and processes
Participate in on-call and off hours coverage. Hours on-call and worked may include evenings, weekends, and holidays
Adhere to •Pledge of Confidentiality • Information regarding a patient of this company shall not be released to any source outside of this company without the signed permission of the patient. Furthermore, information will only be released internally on a need-to-know basis. All Team Members will not discuss patient cases outside the office or with anyone not employed by this company unless they are directly involved with the patient's case
Qualification
Required
High School Diploma or GED
Two (2) or more years of experience with Insurance verifications, which include gathering prior authorization required documents and submitting/following-up prior authorizations requests to payors
Direct experience using payor portals
Highly accurate with pertinent information. e.g. reference #s, dates, spelling of names, ID#s, phone #s, email addresses
Consistently detailed oriented and thorough
Advanced written and verbal communication skills, to include excellent grammar
Advanced reading and comprehension abilities
Advanced analytical skills and detail-oriented
Advanced multi-tasking skills
Advanced organizational and prioritization skills, with strong ability to meet strict deadlines
Proficient typing skills
Proficient with Microsoft Word, Microsoft Outlook, Adobe Acrobat, general internet research, and beginner knowledge of Microsoft Excel
Familiarity with PDF editing
Preferred
Experience with HCPCS procedure codes and ICD-10 codes
Benefits
Medical
Dental
401K with Match
Company
Kestra Medical Technologies, Inc.
Kestra Medical Technologies offers wearable medical devices which collects, store, and communicate patients vital performance data.
51-200 employees
Funding
Current Stage
Public CompanyTotal Funding
$334M2025-12-02Post Ipo Equity· $138M
2025-03-06IPO
2024-07-24Private Equity· $196M
Leadership Team
Timothy Moran
Chief Business Officer
Recent News
2025-12-12
Kestra Medical Technologies, Ltd
2025-12-03
Company data provided by crunchbase