Senior Bedded Insurance Authorization Specialist

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

📋 Description

• Ensure initial and concurrent insurance authorization acquisition, clinical submissions, and denial prevention for patients admitted to the hospital.

• Facilitate staff training and onboarding processes.

• Conduct quality audits to maintain standards.

• Execute unbilled cleanup and reduction tasks.

• Manage pre-bill denials and P2P activities efficiently.

• Verify active health insurance and procedure coverage.

• Confirm and document insurance eligibility and benefits accurately.

• Review and submit clinical documentation that supports medical necessity.

• Obtain and sustain both initial and subsequent insurance authorizations.

• Analyze visit data and payer-specific criteria to ascertain authorization requirements.

• Follow up promptly on authorization requests.

• Achieve over 95% accuracy, quality, and productivity while assisting in and overseeing Specialist assignments.

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

• Support leadership with team engagement and performance metrics.

• Ensure regulatory compliance and provide age-appropriate care-related assistance.

⛳️ Requirements

• Minimum of 2 years experience in customer service.

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

• In-depth knowledge of insurance authorization prerequisites, contract benefits, CPT codes, and medical terminology.

• Strong critical thinking and problem-solving abilities.

• Excellent verbal and written communication skills.

• Capacity to manage stressful situations and juggle multiple tasks simultaneously.

• Proficient in using personal computers and standard office equipment.

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

• High School Diploma or GED is required.

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

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

🏝️ Benefits

• Bonus incentives available.

• Coverage for paid certifications.

• Tuition reimbursement offered.

• Comprehensive benefits package, including healthcare, time off, retirement plans, and well-being programs.

• Opportunities for career advancement.

• Professional development support.

• Participation in quarterly and annual incentive programs.

• Flexibility of remote work options.

• Company-sponsored CRCR certification within 6 months of hire.