Remote Medical Authorization & Billing Specialist

Proliance Surgeons; Issaquah (WA); Remote; USD 45,000 - 65,000; Full time

Job summary

Proliance Surgeons is seeking an Authorization and Benefits Specialist to manage accounts receivable while ensuring excellent customer service. The role focuses on obtaining prior authorizations for procedures and coordinating with patients, clinics, and insurers.

Fully remote but requires current location or willingness to relocate to specified states and ability to work PST hours; two years healthcare AR/billing experience and Medicare familiarity are preferred.

Qualifications

• High School diploma/GED or equivalent.
• 2 years experience in a healthcare facility related to accounts receivable or billing.
• Medicare experience preferred.
• Insurance experience across commercial, workers' comp and government payers.

Responsibilities

• Coordinate and process medical prior authorizations for surgical procedures by reviewing insurance and submitting required information.
• Triage calls and requests from providers/patients for authorization of services and status updates.
• Maintain professional communication with patients, clinic staff, and outside vendors via phone or written documentation; respond to inquiries.
• Know healthcare plan requirements and networks; stay updated on changes.
• Verify and document insurance information per current business practices.
• Post all payments from patients, attorney offices, and/or insurers accurately.
• Review Explanation of Benefits (EOB), research denials and reductions.
• Use required forms for adjustments, insurance transfers, or account changes.
• Prepare and submit timely claims to third-party insurers electronically or on paper.
• Follow up with patients or insurers on unpaid/denied claims; document per policy.
• Address credit balances to determine refunds due to patient or insurer.
• Other duties as assigned.

Skills

Customer service

Attention to detail

Time management

Team player

Communication

HIPAA compliance

Education

High School diploma/GED

Job description

Proliance Surgeons is seeking an Authorization and Benefits Specialist to manage accounts receivable while ensuring excellent customer service. The role focuses on obtaining prior authorizations for procedures and coordinating with patients, clinics, and insurers.

Fully remote but requires current location or willingness to relocate to specified states and ability to work PST hours; two years healthcare AR/billing experience and Medicare familiarity are preferred.