Prior Authorization & Benefits Specialist

Proliance Surgeons; Renton (WA); On-site; USD 42,000 - 60,000; Full time

Job summary

Proliance Surgeons in Renton, WA is seeking an Authorization and Benefits Specialist to manage accounts receivable and obtain prior authorizations for procedures. The role requires at least 2 years of authorization/benefits experience, healthcare billing familiarity, and Medicare/insurance knowledge.

Standard clinic hours are Monday–Friday, 8:30am–4:30pm, with training for surgical scheduling. Proliance Surgeons offers competitive benefits and pay.

Qualifications

• Must have at least 2 yrs of prior authorization and benefits experience, ideally in a clinic setting.
• Experience in healthcare facility accounts receivable or billing practices preferred.
• Medicare experience strongly preferred.
• Insurance experience and knowledge in commercial, work comp, and government payers required.

Responsibilities

• Coordinate and process medical prior authorizations for surgical procedures by reviewing insurance and submitting information needed for coverage.
• Triage incoming calls and requests from provider groups/patients for authorization of services; respond to inquiries.
• Maintain professional communication with patients, clinic personnel, and outside vendors via phone, email or other written documentation.
• Verify and document insurance information; post all payments received from patients, attorney offices and/or insurers.
• Review EOBs, research denials/reductions; prepare, submit and ensure timely claim accuracy for billing to third party carriers.
• Follow up on unpaid, denied or rejected billing claims by outbound and inbound calls; document according to policy.
• Assist with surgery scheduling (will train) and other duties as assigned.

Skills

Authorization experience

Billing

Insurance knowledge

Customer service

Education

High School diploma/GED

Job description

Proliance Surgeons in Renton, WA is seeking an Authorization and Benefits Specialist to manage accounts receivable and obtain prior authorizations for procedures. The role requires at least 2 years of authorization/benefits experience, healthcare billing familiarity, and Medicare/insurance knowledge.

Standard clinic hours are Monday–Friday, 8:30am–4:30pm, with training for surgical scheduling. Proliance Surgeons offers competitive benefits and pay.