Billing & Authorization Specialist

This is a fully remote position, open to applicants in South Africa.

📋 Description

• Assess billing codes and insurance authorizations to guarantee accuracy, completeness, and compliance.

• Ensure all necessary authorizations are secured prior to billing for services.

• Track authorizations, manage impending expirations, and secure required extensions.

• Input and uphold authorization and billing details in EMR and billing systems.

• Confirm that services are billed only when valid and suitable authorizations are present.

• Follow up with therapists, clinicians, and providers regarding any missing documentation, treatment details, or authorizations.

• Communicate with insurance companies concerning authorization status, extensions, denials, payer requirements, and billing questions.

• Investigate and address billing discrepancies and authorization challenges.

• Maintain well-organized records of authorizations, billing information, and associated communications.

• Ensure that all processes adhere to payer requirements and company protocols.

• Utilize EMR and/or billing software employed by Early Intervention or pediatric healthcare providers.

• Identify authorization or billing concerns before they impact service delivery or reimbursement.

• Collaborate with internal teams to efficiently resolve outstanding issues.

⛳️ Requirements

• Previous experience in medical billing and insurance authorizations.

• Strong knowledge of CPT codes, medical billing procedures, and payer expectations.

• Experience in managing insurance authorizations, including obtaining, updating, extending, and addressing denied or missing authorizations.

• Exceptional attention to detail and accuracy.

• Strong organizational and administrative capabilities.

• Ability to handle multiple authorizations, deadlines, and follow-ups concurrently.

• Comfortable engaging professionally with therapists, clinicians, healthcare providers, and insurance companies.

• Strong problem-solving abilities and the capacity to investigate and resolve discrepancies independently.

• Experience with EMR and/or medical billing software.

• Background in pediatric healthcare, pediatric therapy, Early Intervention, behavioral health, or a comparable healthcare setting would be highly beneficial.

🏝️ Benefits

• Competitive salary and compensation package.

• Opportunities for professional development and training.

• Collaborative and supportive work environment.

• Flexible working hours.

• Comprehensive health benefits and wellness programs.