Remote Benefits & Authorization Lead

Nira Medical Group; United States; Remote; USD 60,000 - 82,000; Full time

Job summary

Nira Medical Group is seeking a Benefits and Authorizations Specialist Lead to verify insurance coverage, manage pre-authorizations, and coordinate financial assistance for medical and infusion services in a remote, full-time capacity in the United States.

You will lead the team, verify eligibility, obtain authorizations, assist with denials, stay current with payer rules, and communicate patient financial responsibilities, while helping patients access programs.

Qualifications

• High school diploma or equivalent (required).
• 2–3 years of experience in medical insurance verification and prior authorizations (infusion services preferred).
• Knowledge of insurance terminology, plan types, structures, and approval types.
• Experience with J-codes, CPT and ICD-10 coding; Athena experience is a plus.
• Strong organizational skills, detail orientation, and ability to multitask in a fast-paced setting.

Responsibilities

• Verify and document insurance eligibility, benefits, and coverage for all office visits and infusion services.
• Obtain insurance authorization and pre-certification for visits and infusion services.
• Facilitate insurance denial mitigation steps such as peer-to-peer reviews and appeals.
• Maintain knowledge of infusion drug authorization requirements for payers and regulatory guidelines.
• Calculate and communicate patient financial responsibility; provide financial assistance information to patients.

Skills

Insurance verification

Pre-authorizations

Financial assistance

Team leadership

Organizational skills

Attention to detail

Communication

Education

High school diploma or equivalent

Tools

Athena

Job description

Nira Medical Group is seeking a Benefits and Authorizations Specialist Lead to verify insurance coverage, manage pre-authorizations, and coordinate financial assistance for medical and infusion services in a remote, full-time capacity in the United States.

You will lead the team, verify eligibility, obtain authorizations, assist with denials, stay current with payer rules, and communicate patient financial responsibilities, while helping patients access programs.