Pre-Auth & Insurance Billing Specialist

Excelsior Orthopaedics, LLP; Eggertsville (NY); Presencial; USD 42 000 - 54 000; Tempo integral

Resumo da oferta

Excelsior Orthopaedics, LLP in New York (Eggertsville) is seeking a Pre-Authorization Specialist to obtain pre-authorizations and document authorization details in the EMR. You will verify physician orders, explain patient cost sharing, and assist the billing team with researching denied claims. Strong coding knowledge and medical terminology are required, with MEDENT experience preferred. This is a full-time on-site role.

Qualificações

• Knowledge of CPT, HCPCS, and ICD-10 codes is highly preferred.
• Medical terminology is required.
• EMR experience is required; MEDENT preferred.

Responsabilidades

• Obtains pre-authorizations/pre-certification per payer requirements for services rendered.
• Ensures authorization information is documented in the system.
• Verifies physician orders are accurate and understandable.
• Communicates insurance co-pays, deductibles, co-insurances, and out-of-pocket expenses for point-of-service collections.
• Collaborates with billing to resolve rejected or denied claims as needed.
• Keeps management informed of changes in authorization processes and policy updates.

Conhecimentos

CPT/HCPCS/ICD-10 knowledge

EMR experience (MEDENT preferred)

Medical terminology

Effective communication

multitasking

Formação académica

High school degree or equivalent

Ferramentas

MEDENT EMR

Descrição da oferta de emprego

Excelsior Orthopaedics, LLP in New York (Eggertsville) is seeking a Pre-Authorization Specialist to obtain pre-authorizations and document authorization details in the EMR. You will verify physician orders, explain patient cost sharing, and assist the billing team with researching denied claims. Strong coding knowledge and medical terminology are required, with MEDENT experience preferred. This is a full-time on-site role.