Team Lead – Prior Auths, Insurance Verification

GetixHealth

Team Lead in Prior Auths & Insurance Verification at GetixHealth guiding specialists. Oversee insurance verifications and claim resolutions in a fast-paced environment.

Posted 6/18/2026full-timeRemote • Washington • 🇺🇸 United StatesSenior💰 $25 per hourWebsite

About the role

Key responsibilities & impact

Review self-pay accounts to verify insurance coverage.
Analyze and resolve unpaid claims.
Contact insurance carriers for claim status and payments.
Research claims using online tools.
Gather and submit supporting documentation to insurance carriers.
Submit appeals when necessary.
Review and apply contractual terms.
Communicate with patients/guarantors to expedite claims.
Assist with special projects and additional duties as needed.
Ensure compliance with information security policies.
Monitor inventory and provide reporting on open claims.
Report security risks as per procedures.

Requirements

What you’ll need

7+ years’ experience in a facility setting performing insurance follow-up/ denials management
Knowledge of UB04/CMS 1450 and CMS 1500 claim forms, EDI, HCPCS, ICD-9/ ICD-10, CPT, DRG’s and ability to interpret an Explanation of Benefits
Complete working knowledge of billing instructions and procedures for each payer source according to regulations and guidelines
Knowledge of Commercial, Governmental and third-party denials and appeals processes
Knowledge of billing systems
Must have effective organizational skills and a high attention to detail
Medical terminology required
Must demonstrate the ability to adapt to change, maintain professionalism in challenging situations, and work in a Business professional environment
Medi-Cal knowledge a major benefit
High school diploma or college degree from an accredited college or university

Benefits

Comp & perks

Comprehensive Health Coverage: Group medical, dental, and vision plans available from the first day of the month following 90 days of full-time employment.
Life and Disability Insurance: Basic life/AD&D, short-term, and long-term disability coverage provided, with options for voluntary life/AD&D.
401(k) Retirement Savings Plan: Eligible to participate in the company’s 401(k) plan at the beginning of the first calendar quarter following 6 months of continuous service.
Paid Time Off (PTO): Accrue Paid Time Off starting on your first day of employment.
Flexibility in Benefits: The company reserves the right to amend, modify, or terminate any benefits programs as needed.

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills & Tools

insurance follow-updenials managementUB04 claim formCMS 1450 claim formCMS 1500 claim formEDIHCPCSICD-9ICD-10CPT

Soft Skills

organizational skillsattention to detailadaptabilityprofessionalism

Certifications

high school diplomacollege degree