Prior Authorization Specialist - DME

VieMed Healthcare; Lafayette (LA); On-site; USD 36,000 - 54,000; Full time

Job summary

VieMed Healthcare is seeking a detail-oriented Prior Authorization Clerk in Lafayette, LA to manage insurance verification and prior authorizations for DME products. You will coordinate with patients, physicians, and internal teams to ensure timely submissions and accurate documentation.

The role requires 1+ year of insurance verification or authorizations and 2–4 years in DME/medical office settings, with strong knowledge of CPT/ICD-10, HIPAA and billing policies.

Qualifications

• 2–4 years in DME or medical office experience preferred.
• Minimum of 1 year of insurance verification or prior authorizations required.
• Knowledge of CPT/ICD-10 codes, HCFA 1500 forms, HIPAA and billing regulations.
• Understanding Medicare & Medicaid policies and benefits.
• Familiarity with Explanation of Benefits (EOBs).
• General knowledge of government/regulatory billing and compliance.

Responsibilities

• Review and obtain compliant documentation to submit for insurance prior authorization.
• Obtain prior authorization from insurance payors for DME.
• Verify patient demographics and insurance information; process authorizations/appeals.
• Notify management of non-compliance and missed authorization deadlines.
• Maintain communication with patients, physicians’ offices, and internal teams.
• Handle clerical tasks such as answering calls, faxing, and emailing.
• Report concerns to Revenue Cycle Manager and Supervisor.
• Contribute to other duties as assigned.

Skills

Organizational skills

Microsoft Office

Attention to detail

Communication skills

Education

High School Diploma or equivalent

Tools

Billing software

Job description

VieMed Healthcare is seeking a detail-oriented Prior Authorization Clerk in Lafayette, LA to manage insurance verification and prior authorizations for DME products. You will coordinate with patients, physicians, and internal teams to ensure timely submissions and accurate documentation.

The role requires 1+ year of insurance verification or authorizations and 2–4 years in DME/medical office settings, with strong knowledge of CPT/ICD-10, HIPAA and billing policies.