Healthcare Authorization & Claims Specialist

Reliable Respiratory; Concord (NH); On-site; USD 45,000 - 60,000; Full time

Job summary

Reliable Respiratory is a DME company providing CPAPs, oxygen equipment, nebulizers, and related products. The Authorization Specialist reviews active rentals and future claims, ensures proper documentation, prior authorization, and patient eligibility to secure correct payments while delivering exceptional service.

You will work with providers, payors, and patients to gather medical documentation, stay current with insurance guidelines, and support accurate billing and scheduling for equipment

Qualifications

• 18 years of age or older.
• Must be eligible to work in the United States without current or future work authorization.
• Associate's degree or 2 years of relevant experience (authorization, claims, billing).

Responsibilities

• Provide exceptional service to patients, payors, and providers.
• Process and review claims and authorizations to ensure timely payment.
• Ensure accurate scheduling and billing related to equipment rentals.
• Gather and verify medical documentation and insurance details.
• Monitor insurance guidelines and authorization/billing requirements.
• Maintain up-to-date patient charts and insurance information.
• Assist with payments, adjustments, and billing dates.
• Coordinate with clinical teams and providers as needed.
• Identify and escalate issues affecting payor eligibility or coverage.

Skills

Customer Service

Billing

Insurance

Prior Authorization

Documentation

Communication

Problem Solving

Attention to detail

Microsoft Office

Independent work

Education

Associate's degree or 2 years relevant experience

Tools

Office software

Job description

Reliable Respiratory is a DME company providing CPAPs, oxygen equipment, nebulizers, and related products. The Authorization Specialist reviews active rentals and future claims, ensures proper documentation, prior authorization, and patient eligibility to secure correct payments while delivering exceptional service.

You will work with providers, payors, and patients to gather medical documentation, stay current with insurance guidelines, and support accurate billing and scheduling for equipment