Team Lead: Prior Auths & Insurance Verification (Remote)
$52,000–$52,000 year
Remote · United States or Tacoma, Washington, United States
Job Summary
Lead the Insurance Verification and Prior Authorization team, coaching follow-up specialists to verify insurance, resolve unpaid claims, and submit appeals. Drive process improvements, ensure compliance with security policies, monitor open claims, and provide reporting. Requires 7+ years in insurance follow-up/denials, strong knowledge of UB04/CMS forms, EDI, CPT/HCPCS/ICD-9/ICD-10, DRGs, and medical terminology; HS diploma or college degree; healthcare experience in a fast-paced facility setting; and leadership/communication skills. Competitive salary around $25/hour (approx. $52k/year) based on experience, with comprehensive benefits.
Required Qualifications
- 7+ years experience in a facility setting performing insurance follow-up/denials management
- Knowledge of UB04/CMS 1450 and CMS 1500 claim forms, EDI, HCPCS, ICD-9/ ICD-10, CPT, DRG’s and ability to interpret an Explanation of Benefits
- Complete working knowledge of billing instructions and procedures for each payer source according to regulations and guidelines
- Knowledge of Commercial, Governmental and third-party denials and appeals processes
- Knowledge of billing systems
- Medical terminology required
- High school diploma or college degree from an accredited college or university
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