Wound Care Insurance Verification/Authorization Specialist – Part Time

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

📋 Description

• Review and validate patient insurance information, eligibility, and benefits related to Advanced Wound Care and Negative Pressure Wound Therapy.

• Utilize the Medicare portal to confirm hospital or skilled nursing status.

• Initiate, follow up on, and secure authorizations from third-party payers for HCPCS codes associated with wound care.

• Monitor pending authorizations within management-designated time limits.

• Process authorizations through payer portals, fax, or phone communication.

• Obtain retrospective authorizations and single case agreements for patients who are out of network.

• Acquire authorization renewals and confirm active physician written orders along with certification of medical necessity.

• Collaborate with the NPWT Customer Care team to gather necessary documentation.

• Verify authorization quantities and effective dates, ensuring proper entry into systems.

• Organize tasks to prevent revenue loss due to filing limitations.

• Accurately input Payer Plan ID numbers and data into relevant systems for precise billing.

• Assess insurance liability, coordinate benefits, and determine patient financial responsibility.

• Perform additional duties as assigned.

• No supervisory responsibilities.

⛳️ Requirements

• Associate degree (A.A.) or equivalent; two to four years of related experience and/or training; or a comparable combination of education and experience.

• Familiarity with insurance payers and medical benefits.

• At least two years of experience in a healthcare environment.

• Strong organizational skills.

• Knowledge of medical terminology.

• Effective troubleshooting abilities.

• Capability to work collaboratively within a team.

• Ability to independently meet tight deadlines in a project-driven setting.

• Adhere to departmental processes and procedures.

• Highly motivated and detail-oriented.

• Proficiency with Electronic Medical Record Systems.

• Intermediate problem-solving skills.

• Intermediate troubleshooting expertise.

🏝️ Benefits

• Health plan options that include employer contributions.

• Health Savings Account (HSA).

• Healthcare and Dependent Care Flexible Spending Accounts (FSA).

• Dental and Vision premiums covered by InfuSystem.

• Life Insurance, Short-Term Disability (STD), and Long-Term Disability (LTD).

• Paid Parental Leave.

• Adoption and Fertility Assistance.

• 401(k) with a specified Company Match.

• Employee Stock Purchase Program.

• Tuition Assistance.

• Generous Paid Time Off plan.

• Employee Assistance Program.

• Competitive Pay.

• Employee Referral Bonus.