Medical Insurance Authorization Specialist

Job Overview
We are seeking a proactive and detail-oriented Medical Insurance Authorization Specialist to join our healthcare team. In this vital role, you will be responsible for managing insurance authorizations, verifying coverage, and ensuring timely approval for patient services. Your expertise will help streamline the authorization process, reduce delays, and enhance patient care experiences. This position offers an exciting opportunity to work within a dynamic medical environment, utilizing your knowledge of managed care and medical coding to facilitate seamless insurance interactions.

Responsibilities

• Obtain prior authorization and pre-certification from insurance providers for oral sleep appliances and follow up appointments
• Verify patient insurance coverage and benefits accurately using insurance portals and verification systems.
• Review medical records, documentation, and clinical notes to support authorization requests in compliance with HIPAA regulations.
• Utilize CPT (Current Procedural Terminology), ICD-9, ICD-10, and ICD coding systems to prepare accurate documentation for insurance submissions.
• Communicate effectively with healthcare providers, insurance companies, and patients to resolve authorization issues promptly.
• Maintain detailed records of all authorization requests, approvals, denials, and follow-up actions in the medical records system.
• Stay updated on managed care policies, insurance guidelines, and coding changes to ensure compliance and efficiency in the authorization process.

Experience

• Prior experience working in a medical office setting or dental office environment is highly preferred.
• Strong knowledge of managed care processes, insurance verification procedures, and medical billing practices.
• Familiarity with HIPAA regulations to ensure patient confidentiality during all interactions.
• Proficiency in medical terminology, medical records management, and medical coding including CPT, ICD-9, ICD-10, and ICD coding systems.
• Experience with insurance authorization workflows within a healthcare or dental office setting is advantageous.
• Excellent organizational skills with the ability to handle multiple tasks efficiently while maintaining attention to detail.
• Office experience demonstrating proficiency with electronic health records (EHR) systems or similar software. Join us in making a difference by ensuring patients receive the care they need without unnecessary delays! We value energetic professionals who are eager to contribute their expertise in managed care and medical coding while providing exceptional service within a collaborative team environment.

Pay: $24.23 - $29.18 per hour

Work Location: In person