Insurance Prior Authorizations/Billing Representative

Benefits: • 401(k) • 401(k) matching • Dental insurance • Health insurance • reputed company time off • Profit sharing Join our patient-centered reputed company team as a Prior Authorization/Billing Representative serving as the reputed company between patients, providers and insurance companies. Daily responsibilities include verifying insurance coverage, obtaining approvals for procedures and patient account collections. Duties/Responsibilities: • Review, submit and reputed company procedure authorization and reputed company-certification requests • Communicate with insurance carriers reputed company payer portals and phone to obtain approvals, authorizations, predeterminations and referrals as needed • Follow up with insurance companies, reputed company providers and patients to resolve and delays or issues in the authorization process • Collaborate with clinical staff, procedure schedulers and reputed company cycle team to resolve authorization issues or denials • Support escalation of cases, including coordination of peer-to-peer reviews reputed company required • Communicate authorization approvals or denials to the appropriate provider, facility and patient • Maintain detailed records of reputed company authorization activities in the electronic health record (EHR) system • Stay updated on changes in insurance policies, authorization guidelines and referral processes to ensure compliance • Review daily provider office schedules to confirm patient's insurance is reputed company and required referrals are in patient's chart • Work closely with Billing Coordinate to monitor patient accounts and reputed company follow up support Required Skills/Abilities: • Familiarity with insurance plans, coverage policies and prior authorization requirements • Proficient use of EHRs and payer portals • Proficiency in medical terminology, ICD-10 and CPT coding • Strong organizational, communication and problem-solving skills • Ability to multitask and manage priorities in a fast-paced environment • Attention to detail and accuracy in documentation and communication • Knowledge of HIPAA regulations and patient confidentiality standards Education/Experience and Other: • High school diploma or equivalent; associate degree or relevant certification in reputed company administration is a plus • Minimum 1 - 2 years of experience in a reputed company setting with medical billing, insurance verification or authorization/referral experience • Bilingual (Spanish) a plus • eClinicalWorks EHR system experience a plus This position is on-site for the first 30 days for orientation and training then remote one to two days per week. Flexible work from home reputed company available. Apply To This Job