Lead Benefits and Authorization Specialist

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

📋 Description

• Act as the main point of contact for Benefits and Authorization Specialists, offering daily guidance and support.

• Facilitate the onboarding and training process for new team members.

• Oversee departmental work queues to ensure timely completion of insurance verification and authorization requests.

• Evaluate work for precision and offer coaching opportunities as necessary.

• Address payer issues, authorization delays, and workflow challenges by escalating them to the RCM Director.

• Contribute to the creation and upkeep of departmental policies and procedures.

• Foster collaboration among Revenue Cycle, Clinical Operations, Scheduling, Surgery Scheduling, and other relevant departments.

• Confirm patient insurance eligibility and benefits for upcoming appointments and procedures.

• Verify coverage specifics, including deductibles, co-pays, coinsurance, and out-of-pocket maximums.

• Sustain individual productivity while providing direction, training, quality assessment, and workflow management for the Benefits and Authorization team.

⛳️ Requirements

• High school diploma or equivalent is mandatory; an Associate's degree is preferred.

• A minimum of 4-5 years of experience in medical billing, benefits verification, or authorization management is required.

• Preferably 1-2 years of experience in healthcare leadership, mentoring, or supervisory roles.

• In-depth knowledge of medical insurance plans, including commercial, Medicare, Medicaid, and Tricare.

• Advanced comprehension of prior authorization requirements and payer policies.

• Familiarity with medical terminology and CPT/ICD-10 coding.

• Experience with practice management systems and electronic health record (EHR) platforms.

• Strong understanding of medical coding, third-party payer processes, and revenue cycle operations.

• Excellent communication and customer service abilities.

• Proficiency in Microsoft Office applications, particularly Word and Excel.

• Strong written and verbal communication skills.

• Outstanding organizational, analytical, and problem-solving capabilities.

• Ability to handle multiple priorities while maintaining a high degree of accuracy.

• Proven ability to work collaboratively and effectively within multidisciplinary teams.

• Must demonstrate responsibility, reliability, and the capacity to independently perform job functions.

🏝️ Benefits

• Comprehensive health and wellness benefits.

• Competitive salary and opportunities for advancement.

• Generous paid time off and holiday schedule.

• Retirement savings plan with employer match.

• Ongoing professional development and training opportunities.