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Insurance Specialist – Prior Authorization
Meduit | Driving Revenue Cycle PerformanceInsurance Specialist focusing on resolving billing challenges in healthcare revenue cycle management. Utilizing expertise in patient billing and claims submission to ensure accurate payments.
About the role
Key responsibilities & impact- Reduce outstanding accounts receivable by managing claims inventory
- Speak to patients and insurance companies in a professional manner regarding their outstanding balances
- Gather information from patients, clients/family members, client clinical areas, government agencies, employers, third party payors and/or medical payment programs, etc. both in-person and by telephone to register patients, gather or update information, obtain referrals and pre-authorizations, complete appropriate forms, conduct evaluations, determine benefits and eligibility (insurance, public programs, etc.), determine financial responsibility and/or to identify sources of payment for services
- Request, input, verify, and modify patient’s demographic, primary care provider, and payor information
- Provide excellent customer service and timely response to questions and issues related to benefits, billing, claims, payments, etc.
- Answer questions by phone and provide quotes for services; identify financial resources, etc. in accordance with the client policies and procedures
- Utilize various databases and specialized computer software for revenue cycle activities including eligibility verifications, pre-authorizations, medical necessity, review/updating of patient accounts, etc.
- Explain charges, answer questions, and communicate a variety of requirements, policies, and procedures regarding patient financial care services and resources to patients, staff, payors, and agencies
- Work with Claims and Collections in order to assist patients and their families with billing and payment activities
Requirements
What you’ll need- High School Diploma/GED
- 2+ years of Denials Management experience
- 2+ years Medical Billing/Follow-up experience
- Medicare, Medicaid, and commercial payor experience
- Experience with Workers Comp Pre-Access
- Proficiency with PC-based applications (Microsoft Outlook, Word, and Excel)
- Download speed of 30MB or higher & upload speed of 10MB or higher are REQUIRED.
- Access to a Secure and Private workspace (a space in which no one can hear or see you as you may have protected health information on your screen or you may say names, social security numbers or other PHI)
- Employment eligibility: Must be legally authorized to work in the United States without sponsorship
- As a condition of employment, a pre-employment background check will be conducted
Benefits
Comp & perks- Comprehensive paid training
- Medical, dental, and vision insurance
- HSA and FSA available
- 401(k) with company match
- Paid Wellness Time and Holidays
- Employer paid life insurance and long-term disability
- Internal growth opportunities
ATS Keywords
✓ Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills & Tools
Denials ManagementMedical BillingClaims ManagementEligibility VerificationPre-AuthorizationFinancial Responsibility AssessmentPatient Account ReviewData EntryBilling ProceduresInsurance Verification
Soft Skills
Customer ServiceCommunicationInterpersonal SkillsProblem SolvingAttention to DetailProfessionalismOrganizational SkillsTime ManagementEmpathyTeam Collaboration
Certifications
High School DiplomaGED