Benefits and Authorizations Specialist

Nira Medical; Poland; On-site; PLN 50,000 - 70,000; Full time

Job summary

A healthcare provider in Poland is seeking a Benefits Specialist responsible for verifying patient insurance coverage and assisting with financial support for medical services. The ideal candidate will have 2-3 years of experience in medical insurance verification, with strong organizational and critical thinking skills. Responsibilities include documenting benefits, obtaining authorizations, and providing assistance to patients navigating their financial responsibilities. Knowledge of medical coding is a plus.

Qualifications

• 2-3 years of experience in medical insurance verification and prior authorizations.
• Knowledge of insurance terminology and approval types.
• Previous experience with J-codes, CPT and ICD-10 coding.

Responsibilities

• Verify and document insurance eligibility and benefits.
• Obtain insurance authorization for services.
• Facilitate insurance denial mitigation steps.

Skills

Medical insurance verification

Organizational skills

Critical thinking

Attention to detail

Multi-tasking

Education

High school diploma or equivalent

Tools

Athena

Job description

Job Summary

The Benefits Specialist is responsible for verifying patient insurance coverage, submitting pre-authorizations, and financial assistance support to ensure patients receive coverage for medical and infusion services provided.

Key Responsibilities

• Verify and document insurance eligibility, benefits, and coverage for all office visits and infusion services.
• Obtains insurance authorization and pre-certification for office visits and infusion services.
• Facilitate insurance denial mitigation steps such as peer-to-peer reviews and appeals.
• Maintains a good working knowledge of infusion drug authorization requirements for all payers, state and federal regulatory guidelines for coverage and authorization.
• Calculate and communicate patient financial responsibility.
• Provide financial assistance support to patients including identifying patient assistance programs and manufacturer copay assistance enrollment.

Qualifications

• High school diploma or equivalent
• 2-3 years of experience in medical insurance verification and prior authorizations. Experience in infusion services is preferred.
• Knowledge of insurance terminology, plan types, structures, and approval types
• Previous experience with J-codes, CPT and ICD-10 coding
• Previous Athena use a plus, but not a requirement
• Knowledge of medical terminology and clinical documentation review
• Strong organizational skills
• Detail-oriented
• Ability to multi-task and work well in a fast-paced setting
• Critical thinking skills and decisive judgment