Billing Specialist – Precertifications & Payer Auth

Southwest Airlines; Honolulu (HI); Hybrid; USD 42,000 - 55,000; Full time

Job summary

Advanced Diabetes Supply is seeking a Billing Specialist to obtain pre-certifications and prior authorizations for DME codes, coordinating with commercial payers. This role operates within Insurance & Billing leadership guidelines to ensure accurate, timely processing.

The ideal candidate will handle insurance verification, billing tasks, and maintain compliant documentation while supporting patients and clinicians in a fast-paced environment.

Qualifications

• Knowledge of insurance verification and/or authorization, billing, and processing claims.
• Basic knowledge of billing guidelines for Medicare and private insurance.
• Familiarity with insurance portals and medical/insurance terms.
• Proficiency in basic math and business calculations.
• Ability to learn new computer systems and data entry tasks.
• MS Office proficiency.

Responsibilities

• Initiates prior authorization submissions and follows up with payors until determination.
• Submits pre-certification information via calls or web portals and tracks status.
• Performs follow-up calls to insurance companies and logs approvals.
• Communicates with patients, doctors, and insurers as needed to complete tasks.
• Ensures documentation is complete and compliant with HIPAA and billing guidelines.
• Maintains accurate notes in the company system and updates medical records as required.
• Remains adaptable to process changes and contributes feedback to improve policies.
• Attends department and team meetings and participates in special projects as needed.

Skills

Insurance verification

Authorization

Billing knowledge

Data entry

Basic math

Computer literacy

Communication

Education

High School Diploma or equivalent

Tools

MS Office

Insurance portals

Job description

Advanced Diabetes Supply is seeking a Billing Specialist to obtain pre-certifications and prior authorizations for DME codes, coordinating with commercial payers. This role operates within Insurance & Billing leadership guidelines to ensure accurate, timely processing.

The ideal candidate will handle insurance verification, billing tasks, and maintain compliant documentation while supporting patients and clinicians in a fast-paced environment.