[Remote] VOB and Prior Authorization Specialist

Note: The job is a remote job and is open to candidates in USA. Triton Medical Solutions is a medical billing company located in Tempe, Arizona, seeking a Part-Time Remote Insurance Verification and Prior Authorization Specialist. The role involves obtaining prior authorization approvals from insurance companies and ensuring necessary procedures are covered for providers across the country. Responsibilities • Verify patients medical plan benefits and requirements according to their specific medical policy, to ensure necessary procedures are covered by an individual’s provider and maximum payment for services rendered. • Handle incoming and outgoing calls from internal team members, insurance payers, and customers related to insurance benefits. • Identify important patient and demographic information that are missing and update information to avoid claim processing issues with the insurer. • Create or build charts for provider’s offices from faxed in documentation. • Determine if prior authorization and/or gap exception is required for ordered services. • Ensures appropriate clinical documentation is available and complete before submitting the prior authorization and/or gap exception. • Send clinical documentation to the insurance company for review and approval. • Follow up with insurance companies to ensure documentation has been received and prior authorization and/or gap exception is in process. • Obtain and review prior authorization and/or gap exception approval and upload approval documentation to the patient’s chart. • Communicate to our providers that the approval is complete, and patient is ready to be seen for services. • Ensure security and confidentiality of data and office technology. • Perform additional daily tasks and/or special projects, as necessary. Skills • General knowledge of insurance cards, medical insurance terminology, medical benefits, and CPT and ICD 9/10 coding. • Previous experience with a medical billing company in the accounts resolution or claim appeals department. • Previous experience with certified medical billing software. • Excellent interpersonal skills. • Attention to accuracy and detail in all aspects of responsibilities. • The ability to manage priorities and focus on completing tasks efficiently and within time frames. • Experience performing research utilizing the Internet. • Excellent organizational skills. • Experience implementing and managing organizational protocols. • Flexibility and a willingness to perform other reasonable duties as requested. Company Overview • Triton Medical Solutions specializes in medical billing, dental billing, revenue cycle management, commercial and Medicare contracting. It was founded in 2011, and is headquartered in Azusa, California, USA, with a workforce of 51-200 employees. Its website is https://tritonmedicalsolutions.com/. Apply tot his job Apply To this Job