Benefits and Authorization Specialist (Chesapeake (Specialty Care)
$39,500–$59,300 year
RemoteUnited States
Job Summary
Verify patient insurance eligibility and benefits for all scheduled appointments, confirming coverage details and documenting information accurately in the practice management system. Obtain prior authorizations for medical and surgical procedures across specialties, including audiology, ENT, plastic surgery, and physical therapy, while tracking status and ensuring timely renewals. Communicate benefit details and demographic errors to office scheduling staff and resolve billing complaints from patients and insurance companies. Adhere to Medicare compliance regulations and HIPAA guidelines while participating in revenue cycle meetings and process improvement initiatives. Maintain strict confidentiality and stay current on payer policies to minimize claim denials and billing surprises.
Required Qualifications
- High school diploma or equivalent
- Minimum 2-3 years of experience in medical billing
- Strong knowledge of medical insurance plans (commercial, Medicare, Medicaid, Tricare)
- Familiarity with medical terminology and CPT/ICD-10 codes
- Experience with practice management systems and EHR platforms
- Excellent communication and customer service skills
- Knowledge of basic medical coding and third-party operation procedures and practices
- Ability to operate a multi-line telephone system and answer a telephone in a pleasant and helpful manner
- Familiarity with Microsoft applications, including, but not limited to Word and Excel
- Strong written and verbal communication skills including the ability to confidently speak to patients
- Excellent organizational skills to manage multiple tasks throughout the day
- Demonstrate the ability to work as a team player in a very cohesive medical practice
- Ability to communicate and work well with co-workers
- Open and honest communication
- Ability to effectively communicate orally and in writing with internal and external business professionals
- Must be responsible, reliable, and able to carry out job functions
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