PRP Authorization Specialist Maryland Medicaid

IOU Billing Services; Town of Montgomery (NY); Remote; USD 52,000 - 70,000; Full time

Benefits offered by this job

401(k)

401(k) matching

Bonus based on performance

Competitive salary

Dental insurance

Health insurance

Paid time off

Vision insurance

Job summary

IOU Billing Services in Montgomery, NY is seeking an Authorization Specialist to own the prior authorization workflow essential for Maryland Medicaid. You will verify eligibility, manage authorizations, and liaise with payers and providers to keep billing on track.

The role requires meticulous attention to detail, comfort with fast-paced environments, and a focus on accuracy in documentation and approvals. Remote work is offered for this position.

Qualifications

• 5+ years of experience in medical billing, prior authorization, or insurance verification for PRP Maryland Medicaid.
• Familiarity with ICD-10, CPT codes, and medical terminology.
• Experience working with insurance portals and electronic health record (EHR) systems.
• Strong attention to detail and ability to manage multiple tasks simultaneously.
• Excellent communication skills for interacting with payers, providers, and patients.
• Knowledge of payer authorization requirements and managed care guidelines.
• Experience in Icanotes EHR, Waystar, Inovalon, Availity and Carelon Provider Connect.

Responsibilities

• Process and manage prior authorizations and pre-certifications in a timely manner
• Verify patient insurance eligibility and benefits to ensure coverage accuracy
• Communicate with insurance carriers, providers, and clinical staff to obtain necessary approvals
• Track and follow up on pending authorizations to prevent delays in service
• Maintain accurate documentation of authorization requests, approvals, and denials
• Review and interpret payer-specific authorization requirements and guidelines
• Support the billing team by resolving authorization-related claim denials and discrepancies

Education

5+ years of experience in medical billing, prior authorization, or insurance verification for PRP Maryland Medicaid

Tools

Icanotes EHR

Waystar

Inovalon

Availity

Carelon Provider Connect

Job description

Benefits

• 401(k)
• 401(k) matching
• Bonus based on performance
• Competitive salary
• Dental insurance
• Health insurance
• Paid time off
• Vision insurance

About the Role

IOU Billing Services in Montgomery, NY is looking for a detail-oriented Authorization Specialist to join their growing team! In this critical role, you'll be at the heart of the billing process, ensuring accurate and timely authorizations that keep operations running smoothly for Maryland Medicaid. Experience Required. If you thrive in a fast-paced environment and have a passion for precision, this is the opportunity for you.

Responsibilities

• Process and manage prior authorizations and pre-certifications in a timely manner
• Verify patient insurance eligibility and benefits to ensure coverage accuracy
• Communicate with insurance carriers, providers, and clinical staff to obtain necessary approvals
• Track and follow up on pending authorizations to prevent delays in service
• Maintain accurate documentation of authorization requests, approvals, and denials
• Review and interpret payer-specific authorization requirements and guidelines
• Support the billing team by resolving authorization-related claim denials and discrepancies

Requirements

• 5+ years of experience in medical billing, prior authorization, or insurance verification for PRP Maryland Medicaid required.
• Familiarity with ICD-10, CPT codes, and medical terminology
• Experience working with insurance portals and electronic health record (EHR) systems
• Strong attention to detail and ability to manage multiple tasks simultaneously
• Excellent communication skills for interacting with payers, providers, and patients
• Knowledge of payer authorization requirements and managed care guidelines
• Experience in Icanotes EHR, Waystar, Inovalon, Availity and Carelon Provider Connect

About Us

IOU Billing Services is a trusted billing and revenue cycle management company based in Montgomery, NY, dedicated to helping healthcare providers maximize reimbursements and streamline their billing processes. Our clients rely on us for our expertise, accuracy, and commitment to results. Our team enjoys a collaborative and supportive work environment where every employee plays a meaningful role in the company's success.

Location

This is a remote position.