Benefits and Authorizations Specialist

This is a fully remote position, open to applicants in United States.

📋 Description

• Verify and document the eligibility, benefits, and coverage of insurance for all office visits and infusion services.

• Obtain insurance authorization and pre-certification for office visits and infusion treatments.

• Assist with mitigating insurance denial through steps like peer-to-peer reviews and appeals.

• Maintain a comprehensive understanding of infusion drug authorization requirements across all payers, as well as state and federal regulatory guidelines for coverage and authorization.

• Calculate and communicate the financial responsibility of patients.

• Offer financial assistance support to patients by identifying patient assistance programs and facilitating manufacturer copay assistance enrollment.

⛳️ Requirements

• High school diploma or equivalent.

• 2-3 years of experience in medical insurance verification and prior authorizations, with a preference for experience in infusion services.

• Familiarity with insurance terminology, plan types, structures, and approval types.

• Prior experience with J-codes, CPT, and ICD-10 coding.

• Experience with Athena is a plus, but not mandatory.

• Understanding of medical terminology and clinical documentation review.

• Strong organizational skills.

• Detail-oriented.

• Ability to manage multiple tasks and thrive in a fast-paced environment.

• Critical thinking skills and sound judgment.

🏝️ Benefits

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• We've secured a 50% discount for all Remote Rocketship users.