Authorization & Billing Specialist, Medical Equipment

Reliable Respiratory; Dartmouth (MA); On-site; USD 50,000 - 70,000; Full time

Job summary

Reliable Respiratory is seeking an Authorization Specialist to review rentals, ensure proper documentation, and obtain patient eligibility for successful claim payments while delivering exceptional service to patients, payors, and providers. The role requires strong billing, insurance knowledge, and collaboration with clinicians to resolve issues.

You will manage scheduling, billing dates, and prior authorizations, while staying current on guidelines and communicating clearly with patients and

Qualifications

• 18 years of age or older.
• Eligible to work in the United States and not require work authorization now or in the future.
• Associate's degree or 2 years of relevant (authorization, claims, billing) experience.

Responsibilities

• Provide exceptional service every time.
• Ensure scheduled dates of service for equipment rentals bill on time and correctly.
• Work with providers and patients to obtain necessary and current medical documentation.
• Stay up to date on insurance guidelines and their authorization and billing requirements.
• Perform basic billing functions including credit adjustments and recalculation of billing dates of service to ensure sales orders bill correctly.
• Verify patients' insurance eligibility, including contacting payors to investigate and verify the terms and benefits of patients' insurance policies and costs.
• Facilitate process for requesting prior authorizations for Commercial, Medicaid, and Medicare Policies.
• Work with providers and patients to help them understand requirements for payor coverage including authorization and compliance requirements.
• Process payment for services rendered.
• Evaluate and/or escalation patient accounts that do not meet insurance or provider guidelines.
• Troubleshoot equipment issues with patients.
• Refer issues to the Reliable clinical team, manufacturer's care teams or referring provider as needed.

Skills

Problem solving

Active listening

Decision making

Communication

Proactiveness

Good judgement

Attention to detail

Teamwork

Independence

Prioritization

Compliance

Computer skills

Education

Associate's degree

Tools

Microsoft Office

Job description

Reliable Respiratory is seeking an Authorization Specialist to review rentals, ensure proper documentation, and obtain patient eligibility for successful claim payments while delivering exceptional service to patients, payors, and providers. The role requires strong billing, insurance knowledge, and collaboration with clinicians to resolve issues.

You will manage scheduling, billing dates, and prior authorizations, while staying current on guidelines and communicating clearly with patients and