Insurance Authorization Rep

Blue Cloud Pediatric Surgery Centers; Lansing (MI); On-site; USD 24,796 - 27,552; Full time

Benefits offered by this job

401(k)

Dental insurance

Health insurance

Life insurance

Paid time off

Vision insurance

Job summary

Blue Cloud Pediatric Surgery Centers is looking for an Insurance Authorization Representative to work remotely. Your role involves verifying insurance, engaging with patients regarding coverage issues, and supporting our clinical team. A high school diploma is required, while an associate’s degree and experience in medical/dental billing is preferred. The position offers a full-time schedule with benefits including dental, health, and life insurance, along with a pay rate of $18-$20 per hour.

Qualifications

• Ability to handle multiple responsibilities simultaneously in a deadline-driven environment.
• Strong understanding of benefits investigation: deductibles, co-insurance, out-of-pocket expense, and benefit exclusions.

Responsibilities

• Perform insurance verification and authorizations.
• Engage with insurance companies to address CPT/CDT code discrepancies.
• Provide patients with information regarding coverage.
• Document activity in patient accounts.
• Obtain prior authorization for procedures.

Skills

Customer/Client Focus

Stress Management/Composure

Results Driven

Technical Capacity

Problem Solving/Analysis

Teamwork Orientation

Collaboration Skills

Time Management

Communication Proficiency

Education

High School Diploma or Equivalent

Associate’s degree

Tools

Medical/Dental Billing Software

Job description

Insurance Authorization Representative - Remote

Blue Cloud is the largest pediatric ambulatory surgery center (ASC) company in the country, specializing in dental restorative and exodontia surgery for pediatric and special‑needs patients delivered under general anesthesia. We are a mission‑driven company focused on safe, high‑quality, and accessible care at reduced costs to families and payors.

Overview

As part of our growing ASCs, we are seeking a Patient Service Coordinator to support our clinical team of dentists, anesthesiologists, registered nurses, and dental assistants.

Responsibilities

• Perform insurance verification and authorizations.
• Engage in heavy phone contact with dental and medical insurance companies to address CPT/CDT code discrepancies.
• Contact patients prior to appointments regarding any insurance or authorization issues.
• Provide patients with pertinent information regarding coverage.

Essential Functions

• Accurately enter insurance information into the computer system.
• Pre‑certification/authorization and insurance verification for all patients.
• Obtain prior authorization for procedures.
• Research, follow up, and resolve open & pending authorizations in a timely manner.
• Calculate cash estimates for patients on upcoming visits/procedures.
• Contact patients regarding financial obligations and arrange payments.
• Document activity in patient accounts.
• Maintain clear and concise documentation of all information.
• Communicate with patients and insurance companies while maintaining strict confidentiality.
• Scan medical documents into patient accounts.
• Answer questions from clinics, patients, insurance companies, and staff.
• Adhere to HIPAA guidelines and regulations.
• Perform tasks based on a set schedule and complete general office duties as needed.

Competencies

• Customer/Client Focus
• Stress Management/Composure
• Results Driven
• Technical Capacity
• Problem Solving/Analysis
• Teamwork Orientation
• Collaboration Skills
• Time Management
• Communication Proficiency

Requirements

• High School Diploma or Equivalent.
• Ability to handle multiple responsibilities simultaneously in a deadline‑driven environment.
• Strong understanding of benefits investigation: deductibles, co‑insurance, out‑of‑pocket expense, and benefit exclusions.

Preferred Qualifications

• Associate’s degree.
• Additional coursework in medical/dental billing.
• Previous experience with medical/dental billing software systems.
• 3–5 years in a fast‑paced medical/dental office environment.
• Knowledge of patient registration, scheduling, authorizations, billing, and dental/medical policies.
• Working knowledge of Medicare, Medicaid, BC/BS, Workers Compensation, Managed Care, and commercial insurance billing regulations.
• Strong organization, problem‑solving, and communication skills.

Experience

• Insurance verification: 1 year (Preferred).
• Medical billing: 1 year (Preferred).

Work Location

Remote opportunity in AZ, ID, TN, MO, TX, MD, CO, FL, DE, IL, KS, MI, NV, NC, OH, PA, WV. (Not eligible for CA employees.)

Position Type & Hours

Full‑time, day shift. Monday through Friday with occasional overtime. 40 hours per week.

Benefits

• 401(k)
• Dental insurance
• Health insurance
• Life insurance
• Paid time off
• Vision insurance
• $18‑20 per hour

EEO Statement

Blue Cloud is an equal‑opportunity employer. Consistent with applicable law, all qualified applicants will receive consideration for employment without regard to age, ancestry, citizenship, color, family or medical care leave, gender identity or expression, genetic information, immigration status, marital status, medical condition, national origin, physical or mental disability, political affiliation, protected veteran or military status, race, ethnicity, religion, sex (including pregnancy), sexual orientation, or any other characteristic protected by applicable local laws, regulations, and ordinances.