Senior Bedded Insurance Authorization Specialist

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

📋 Description

• Facilitate the initial and ongoing authorization of insurance, clinical submissions, and denial mitigation for patients admitted to hospitals.

• Oversee training and onboarding procedures for staff members.

• Conduct quality audits to ensure compliance and efficiency.

• Execute cleanup and reduction of unbilled authorizations.

• Manage pre-bill denial processes and P2P activities.

• Verify that patients’ health insurance is active and applicable to their procedures.

• Confirm and document insurance eligibility and benefits.

• Review and submit clinical documentation that supports diagnosis, treatment, services, and medical necessity.

• Obtain, validate, and maintain necessary insurance authorizations.

• Ensure that both initial and subsequent authorizations are secured in a timely manner.

• Analyze patient visit information along with payer-specific criteria to determine authorization requirements.

• Examine visit data for precise clinical information and follow up on authorization acquisition.

• Achieve a minimum of 95% accuracy, quality, and productivity while supporting and overseeing Specialist assignments.

• Conduct quality audits and training sessions for both new hires and experienced associates.

• Engage in daily follow-up and reduction of unbilled authorizations, as well as processing pre-bill denials and P2P activities.

• Assist leadership in enhancing team engagement and performance.

• Deliver age-appropriate care-related support in line with departmental policies and procedures.

⛳️ Requirements

• Minimum of 2 years of experience in customer service.

• Familiarity with insurance companies and/or medical authorization processes.

• Thorough understanding of insurance authorization requirements, contract benefits, CPT codes, and medical terminology.

• Strong critical thinking and problem-solving abilities.

• Quick retention of materials and concepts.

• Positive attitude coupled with excellent verbal and written communication skills.

• Professional demeanor and appearance.

• Capability to manage stressful situations and multitask effectively.

• Proficient in using personal computers and standard office equipment.

• Ability to access online systems for insurance eligibility and pre-certification.

• Must successfully complete any additional job-related requirements.

• High School Diploma or GED is required.

• CRCR certification must be obtained within 6 months of hire.

• Must reside in and have authorization to work in the United States.

🏝️ Benefits

• Comprehensive benefits package that includes healthcare, time off, retirement plans, and well-being initiatives.

• Investment in professional development.

• Support for certification relevant to the associate’s field.

• Tuition reimbursement opportunities.

• Participation in quarterly and annual incentive programs.

• Company-funded CRCR certification within 6 months of employment.

• Flexibility in work-life balance.

• Option for remote work.