Prior Authorization Specialist – Medical Billing

Reliable Respiratory; South Windsor (CT); On-site; USD 28,000 - 40,000; Full time

Job summary

Reliable Respiratory is seeking an Authorization Specialist to review active rentals and future claims, ensuring proper documentation, prior authorization, and patient eligibility for successful payment of claims. The role emphasizes exceptional service to patients, payors, providers, and team members.

Responsibilities include handling billings, updating charts, verifying insurance, and coordinating with the clinical team to obtain necessary documentation.

Qualifications

• 18 years of age or older.
• Must be eligible to work in the United States and not require work authorization from us now or in the future.
• Associate’s degree required or 2 years of relevant (authorization, claims, billing) experience.

Responsibilities

• Provide exceptional service every time.
• Meet or exceed annual performance indicators as outlined by organizational leadership.
• Complete assigned tasks and worklists in a timely manner.
• Ensure scheduled dates of service for equipment rentals bill on time and correctly.
• Ensure supply orders can be placed and delivered to the patients when eligible for new supplies.
• Work with providers and patients to obtain necessary and current medical documentation.
• Stay up to date on insurance guidelines and their authorization and billing requirements.
• Verify patients’ insurance eligibility, including contacting payors to investigate and verify the terms and benefits of patients’ insurance policies and costs.
• Process payment for services rendered.
• Perform other duties and special projects as assigned and directed.

Skills

Customer Service

Communication

Problem Solving

Time Management

Attention to Detail

Microsoft Office Suite

Education

Associate’s degree

Tools

Microsoft Office Suite

Job description

Reliable Respiratory is seeking an Authorization Specialist to review active rentals and future claims, ensuring proper documentation, prior authorization, and patient eligibility for successful payment of claims. The role emphasizes exceptional service to patients, payors, providers, and team members.

Responsibilities include handling billings, updating charts, verifying insurance, and coordinating with the clinical team to obtain necessary documentation.