Wound Care Insurance Verification Specialist
NIVA Health
full-time
Posted on:
Location Type: Remote
Location: South Africa
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Salary
💰 $1,300 per month
Job Level
About the role
- Submit and manage prior authorization requests for wound care treatments
- Handle PCP referrals/authorizations and follow up for smooth patient care
- Prepare and track Single Case Agreements/GAP exceptions
- Communicate with insurance providers to clarify coverage and resolve denials
- Maintain precise records of authorizations, denials, appeals, and documentation
- Stay updated with insurance policies and coding changes
- Collaborate with healthcare providers to gather documentation
- Advocate for patients regarding their authorizations and expenses
- Conduct work with discretion, diplomacy, and tact
Requirements
- 1 year of experience in prior authorization management, specifically within wound care services
- Strong work ethic and self-motivation
- Clear and empathetic communication with patients, staff, and payers
- Understanding of insurance processes, medical terminology, and healthcare systems
- Proficiency with electronic medical records (EMR) and case management software
- Ability to collaborate with multidisciplinary healthcare teams and solve complex problems
- Embody NIVA Health’s Core Values in every interaction.
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills & Tools
prior authorization managementwound care servicesmedical terminologyinsurance processescase management
Soft Skills
strong work ethicself-motivationclear communicationempathetic communicationcollaborationproblem-solvingdiscretiondiplomacytact