Remote Eligibility & Authorization Specialist II

Recovery Innovations; United States; Remote; USD 33,000 - 34,000; Full time

Benefits offered by this job

Competitive benefits

Job summary

Recovery Innovations seeks a Guest Eligibility Specialist II to manage front-end eligibility and authorizations with independence and accuracy. You will verify guest information, review documentation with CPT/HCPCS/ICD-10 coding, and initiate authorizations through portals or fax.

Emphasis on coding knowledge, payer rules, and continuous workflow improvements. Responsibilities include registration, eligibility validation, compliance, documentation, and training of staff.

Qualifications

• 4 years of registration and authorization experience required.
• Knowledge of CMS guidelines and payer requirements.
• Ability to navigate CMS guidelines and coding policies.

Responsibilities

• Register guests and authorization across multiple states.
• Reconcile insurance coverage discrepancies and ensure demographic accuracy.
• Validate complex eligibility situations and escalate when needed.
• Apply advanced CPT/HCPCS/ICD-10 coding when determining authorization needs.
• Ensure adherence to payer requirements and compliance standards.
• Document authorizations and payer communications; train staff as needed.

Skills

HIPAA compliance

MS Excel

Professional communication

Detail-oriented

Education

High school diploma or equivalent

Tools

HCPCS

CPT

ICD-10

Job description

Recovery Innovations seeks a Guest Eligibility Specialist II to manage front-end eligibility and authorizations with independence and accuracy. You will verify guest information, review documentation with CPT/HCPCS/ICD-10 coding, and initiate authorizations through portals or fax.

Emphasis on coding knowledge, payer rules, and continuous workflow improvements. Responsibilities include registration, eligibility validation, compliance, documentation, and training of staff.