Experienced Intake / Verification Specialist

AIS Healthcare; Fort Lauderdale (FL); Remote; USD 40,000 - 80,000; Full time

Job summary

An established industry player is looking for a Benefit Verification and Authorization Specialist to join their remote team. This role requires a minimum of three years of experience in the healthcare sector, focusing on insurance eligibility and authorization processes. The ideal candidate will excel in communication, problem-solving, and possess a keen understanding of compliance regulations. With a commitment to improving lives through innovation, this opportunity offers comprehensive benefits including health insurance, a 401(k) plan, and growth prospects. Join a dynamic team dedicated to making a positive impact in the healthcare industry.

Benefits

Health Insurance

Dental Insurance

Vision Insurance

401(k) Plan with Employer Match

Long-term Disability Insurance

Life Insurance

Vacation Package

Work-from-home

Growth Opportunities

Qualifications

• 3+ years of experience in benefit verification and authorization.
• Knowledge of insurance eligibility and authorization processes.

Responsibilities

• Verify patient insurance eligibility and benefits across various payers.
• Accurate data entry into EHR systems and follow-up on authorizations.

Skills

Communication Skills

Problem-solving Skills

Knowledge of Insurance Eligibility

Data Entry Accuracy

Education

High School Diploma or GED

3-5 Years of Healthcare Experience

Tools

Microsoft Office

EHR Systems

Job description

Job Opportunity: Benefit Verification and Authorization Specialist

Please only apply if you have at least 3 years of intake/verification experience. This is a remote opportunity.

AIS Healthcare, a leader in Targeted Drug Delivery (TDD) and Infusion Care solutions, is committed to advancing quality and improving lives through innovation, stewardship, and unity. We are seeking an experienced and motivated Benefit Verification and Authorization Expert to join our dynamic team. The ideal candidate will possess outstanding communication skills, in-depth knowledge of collection practices, and compliance with federal and state regulations related to benefit verification and authorization activities.

We offer comprehensive benefits, including health, vision, dental insurance, long-term disability, life insurance, a vacation package, a 401(k) plan with a generous employer match, 100% work-from-home, growth opportunities, and more.

Education and Experience

• High school diploma or GED required.
• 3-5 years of healthcare industry experience preferred.
• Experience in Home Infusion and Intrathecal Pain Management is a plus.

Essential Duties and Responsibilities

• Knowledge of patient insurance eligibility and benefits across various payers including Aetna, Cigna, BCBS, Humana, Worker’s Comp, Medicare, and Medicaid.
• Understanding of authorization processes such as GAPs, pre-determinations, PCP referrals, and single case agreements.
• Accurate data entry into EHR systems following standard procedures.
• Follow-up on pending or expired authorizations and referrals.
• Review and contest authorization denials, initiate appeals, and document all interactions.
• Maintain confidentiality and adhere to HIPAA regulations.
• Knowledge of NDC numbers, infusion supplies, medical terminology, billing procedures, and government regulations.
• Collaborate effectively with team members and external stakeholders.
• Perform additional duties as assigned.

Qualifications

• Good judgment and problem-solving skills within legal and regulatory frameworks.
• Excellent communication and relationship-building skills.
• Integrity, credibility, and a strong work ethic.
• Organized, detail-oriented, and self-motivated.
• Proficiency in Microsoft Office applications.

Application Process

Complete the Culture Index Candidate Assessment by following the link provided below. Applications without this assessment will not be considered.

Complete the Culture Index Assessment

We are proud to provide a positive work culture and seek impact players who are positive, earnest, and hardworking.