Medical Prior Authorization & Insurance Speci

Big Sky IV Care; Newark (DE); In loco; USD 45.000 - 65.000; Tempo pieno

Vantaggi offerti da questo lavoro

Medical, dental, and vision insurance

401(k) retirement plan

Paid time off

Paid holidays

No nights, weekends, or major holidays

Stable outpatient medical-office环境

Stable outpatient medical-office环境

Descrizione del lavoro

Infusion Solutions of Delaware seeks a detail-oriented Medical Prior Authorization & Insurance Specialist to join our outpatient practice. The role focuses on coordinating authorizations, verifying coverage, performing benefit investigations, and assisting patients with billing and insurance questions.

The ideal candidate has solid experience in Revenue Cycle Management, medical billing, insurance verification, and prior authorization, with strong attention to detail and clear communication with

Competenze

• Experience in Revenue Cycle Management including medical billing, insurance verification and prior authorization.
• Attention to detail and ability to identify discrepancies across records and bills.
• Strong communication with patients, providers and insurance companies; ability to manage multiple priorities.

Mansioni

• Obtain and process prior authorizations for medications, infusions, injections, procedures and other services.
• Submit authorization requests and clinical documentation to insurers and monitor status.
• Verify patient insurance eligibility and coverage prior to services.
• Perform benefit investigations to determine coverage, deductibles and out-of-pocket costs.
• Maintain accurate documentation within the practice management/EHR system.
• Communicate approvals, denials and documentation requirements to the team and patients.

Conoscenze

Revenue Cycle Management

Medical billing

Insurance verification

Prior authorization

Payment posting

Insurance follow-up

Communication with patients

Strumenti

Practice management system

EHR system

Descrizione del lavoro

Infusion Solutions of Delaware (ISD)is seeking a detail-oriented and patient-focused Medical Prior Authorization & Insurance Specialist to join our team. This position is responsible for coordinating insurance authorizations, verifying patient insurance coverage and benefits, completing benefit investigations, and assisting patients with billing and insurance-related questions.

The ideal candidate has strong knowledge of health insurance processes, excellent attention to detail, and the ability to communicate effectively with patients, insurance companies, providers, and internal team members.

Primary Responsibilities

• Obtain and process prior authorizations for medications, infusions, injections, procedures, and other services as required by insurance carriers.
• Submit authorization requests and supporting clinical documentation to insurance companies.
• Monitor authorization status and follow up with insurance carriers as needed.
• Communicate authorization approvals, denials, and additional documentation requirements to appropriate team members.
• Assist with authorization-related denials and determine next steps, including appeals when appropriate.
• Maintain accurate and timely documentation of all authorization activity.
• Verify patient insurance eligibility and coverage prior to services.
• Perform benefit investigations to determine coverage, deductibles, copayments, coinsurance, out-of-pocket requirements, and authorization requirements.
• Maintain accurate insurance information within the practice management/EHR system
• Communicate effectively with providers, clinical staff, billing staff, patients, and insurance representatives.

Qualifications

• Must have previous experience in Revenue Cycle Management - medical billing, insurance verification, prior authorization, payment posting, insurance follow-up.
• Strong attention to detail and ability to identify discrepancies.
• Ability to manage multiple priorities and meet deadlines and stay organized.
• Comfortable communicating with insurance representatives and patients by phone.
• Preferred:Medical billing or CPC credentials.
• Medical, dental, and vision insurance
• Paid time off
• Paid holidays
• Stable, professional outpatient medical-office environment
• Excellent Salary

Benefits

• Medical, dental, and vision insurance
• 401(k) retirement plan
• Paid time off
• Paid holidays
• No nights, weekends, or major holidays
• Stable, professional outpatient medical-office environment
• Consistent daytime schedule
• Excellent Salary

Equal Opportunity Employer

Infusion Solutions of Delaware, LLC., is an equal opportunity employer