Infusion Insurance & Authorization Specialist

Medix Infusion; Addison (TX); Híbrido; USD 48.000 - 72.000; Jornada completa

Descripción de la vacante

Medix Infusion is seeking an Insurance Specialist to verify insurance eligibility and benefits for infusion services, review medical necessity guidelines, and manage authorizations and appeals. You will collaborate with Intake, Scheduling, Pharmacy, and Clinical teams to ensure timely patient care and accurate documentation in the EMR.

The role requires 2-3 years in healthcare or medical claims, familiarity with Medicare/Medicaid policies, and strong communication.

Formación

• Experience in healthcare, pharmacy, or medical claims billing and coding, including prior authorization and appeals.
• Strong understanding of Medicare, Medicaid, and commercial payer policies.
• Excellent communication and attention to detail required.

Responsabilidades

• Verify insurance eligibility and benefits via phone, fax, or payer portals.
• Ensure timely completion of insurance reviews and documentation in the EMR system.
• Review payer medical policies to confirm medical necessity, including Medicare and FDA guidelines.
• Obtain necessary documentation from medical providers to support medical necessity.
• Submit and follow up on appeal requests for denied authorizations.
• Coordinate with departments to prevent delays in patient care.
• Assist in training staff and attend departmental meetings as needed.

Conocimientos

Healthcare claims experience

Prior authorization

Attention to detail

Communication skills

Educación

High School Diploma or equivalent

Descripción del empleo

Medix Infusion is seeking an Insurance Specialist to verify insurance eligibility and benefits for infusion services, review medical necessity guidelines, and manage authorizations and appeals. You will collaborate with Intake, Scheduling, Pharmacy, and Clinical teams to ensure timely patient care and accurate documentation in the EMR.

The role requires 2-3 years in healthcare or medical claims, familiarity with Medicare/Medicaid policies, and strong communication.