Part Time Authorization and Appeals Specialist

biotabhealthcare; St. Louis (MO); On-site; USD 22,041 - 30,307; Part time

Job summary

BioTAB Healthcare, LLC in Missouri is seeking a part‑time Patient Services Coordinator to support intake, insurance verification, and case management for patient orders. The role handles calls, emails, and CRM tasks, coordinating with sales, clinicians, and internal teams to ensure timely product approvals and coverage.

Ideal candidates have 1+ year of healthcare operations experience, strong organizational skills, and familiarity with HIPAA, CMS guidelines, and insurance processes.

Qualifications

• 1+ years of healthcare operations or similar role experience.
• Must have strong communication and organizational skills.
• Familiarity with HIPAA and patient data handling is required.

Responsibilities

• Process clinical paperwork and review coverage requirements under private insurance, CMS, and patient benefits to obtain product approvals.
• Interface with patients, sales leadership, clinicians, and internal teams daily via calls, emails, CRM, and provider systems.
• Manage documentation for patient charts, shipping, and costs to ensure smooth patient experience.
• Handle benefits, prior authorizations, appeals, and re-certifications.
• Coordinate with teams to ensure equipment coverage and timely processing.
• Respond to service line calls and document interactions in CRM; escalate urgent requests.
• Maintain clear communication with patients, families, and healthcare team members.
• Ensure accurate documentation of all case activities in required systems.
• Prepare cases for review by regulatory agencies and ensure Medicare compliance.
• Work independently and as part of a team, participate in ongoing education.

Skills

Healthcare ops

Customer service

Clear communication

HIPAA literacy

Detail oriented

Education

High School diploma

Associate's degree preferred

Tools

Salesforce

Epic

CRM / office tools

Job description

Overview

For more than 20 years, BioTAB Healthcare, LLC has supported patients with lymphatic, wound, and circulatory disorders through proven treatment solutions. Headquartered in Missouri, we provide pneumatic compression devices and personalized service to help improve patient outcomes and quality of life. As a family‑owned company, we take pride in delivering expert care with a personal touch service.

Job Details

Part‑time, up to 20 hours per week, on site in Maryland Heights. Work hours are between 7:30 am and 4:00 pm; weekends are not required.

Key Responsibilities

• Process clinical paperwork from the sales team, review coverage requirements under private health insurance, CMS, and research patient benefits to obtain product approvals for patient orders.
• Interface with patients, sales leadership, clinicians, and internal teams on a daily basis, handling incoming and outgoing calls, emails, CRM, and provider systems.
• Manage documentation for patient charting, shipping, and cost to ensure a smooth patient experience.
• Handle benefits & prior‑authorizations, appeals, and re‑certifications.
• Review and process cases, order confirmation, re‑work requests, and coordinate with TMs, Bonafide, and calls.
• Respond to incoming service line calls, document interactions in CRM, and direct urgent requests to the appropriate departments or leaders.
• Maintain clear and effective communication with patients, families, and healthcare team members.
• Ensure accurate and timely documentation of all case activities and patient information in the required systems.
• Prepare cases and escalations for review and regulatory agencies, ensuring compliance with Medicare regulations and internal policies.
• Work independently and as a team member, take direction, and participate in continuous education as required.

Patient Intake

Receiving and processing new patient referrals, gathering necessary demographic, medical, and insurance information. This requires outbound and inbound professional communications, interface with BPO partners, and quality control measures.

Insurance Verification

Verifying patient insurance coverage and benefits for BioTAB products, updating cases for record keeping and internal insurance database. Verify patient benefits with insurance companies and manage utilization review activities, requests, and obtain prior authorizations to ensure equipment is covered.

Coordination

Collaborating with sales, patients, and their caregivers or healthcare professionals to get the patient’s products covered, shipped, and in use, with quality and accuracy at the forefront of every case processed. Provide administrative support as needed, including assistance with documentation, communication, and clerical tasks.

Process Management

Answer incoming calls to service lines and provide patient support, answer questions and document interactions & resolutions in CRM. Escalate any urgent requests and direct to correct departments or leaders.

Record Management

Ensuring accurate and timely documentation of all case activities and patient information in the required system. Maintain accurate and organized records of client interactions, service plans, and case management activities. Create and manage electronic consent forms; upload signed forms to patient charts. Complete forms, produce reports on client progress and service delivery, and ensure compliance with organizational policies and regulatory requirements.

Compliance

Ensure compliance with relevant healthcare regulations, financial standards, and internal policies. Prepare cases and escalations for review and other regulatory agencies, assisting in monitoring compliance with Medicare regulations. Adhere to all relevant regulations and agency policies regarding patient intake and data management, including CMS and OFCCP guidelines related to our quality management system, documentation, and process creation and training.

Required Skills & Abilities

• High School or equivalent required; associate’s/bachelor’s degree preferred.
• 1+ years of experience in healthcare operations, customer service, or a similar role or setting preferred.
• Must be able to use Salesforce or Epic, fax, email, GSuite or Office, and handle inbound/outbound calls with appropriate grammar, spelling, and punctuation.
• Strong communication skills, both written and verbal.
• Comfortable handling sensitive and confidential information (HIPAA).
• Excellent organizational and time management skills.
• Attention to detail.
• Knowledge of healthcare regulations and insurance processes.
• Problem‑solving skills.
• Ability to work independently and as a part of a team, take direction, and participate in continuous education as required for the role.
• Strong customer service acumen and an emphasis on process execution and quality control.

Job Requirements & Physical Demands

• Must be able to lift 40 pounds from the floor and lift to waist level.
• Must be able to kneel, stoop, climb stairs, and reach with hands and arms.
• Reliable work transportation.
• Candidates must pass an extensive background check.
• Strict adherence to HIPAA, Medicare Fraud, Waste, and Abuse, and privacy regulations in all patient interactions.

Equal Opportunity Employment

This job description outlines essential duties but is not exhaustive. Employees may be assigned other tasks. All duties are subject to modification for disability accommodation. Successful performance requires specific skills and abilities. This document sets minimum requirements and does not imply an employment contract. The company is an equal opportunity employer, drug‑free workplace, and complies with ADA regulations as applicable.