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Insurance Authorization Specialist

South Shore Therapies

Massachusetts

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JOB DETAILS
SKILLS
Billing, Coding Standards, Communication Skills, Corporate Policies, Current Procedural Terminology (CPT), Dental Insurance, Documentation, Electronic Medical Records, HIPAA (Health Insurance Portability and Accountability Act), Health Insurance, Healthcare Reimbursement, ICD-10, Insurance, Maintain Compliance, Managed Care, Medical Billing, Medical Coding, Medical Protocols, Medical Terminology, Medical Treatment, Microsoft Excel, Microsoft Outlook, Microsoft Word, Multitasking, Organizational Skills, Patient Care, Patient Care Authorizations, Pediatrics, Presentation/Verbal Skills, Problem Solving Skills, Process Management, Record Keeping, Regulatory Compliance, Vision Plan, Writing Skills
LOCATION
Massachusetts
POSTED
3 days ago
Insurance Authorization Specialist – 30 to 40 hrs
Pay: $22-$24/hr
Job description:
South Shore Therapies, a premier pediatric OT and Speech practice, is seeking an Insurance Authorization Specialist to join our billing and authorization administration team. The ideal candidate will possess an understanding of health insurance policies, medical billing, and authorization processes. In this role, you will be responsible for verifying insurance benefit coverage, obtaining prior authorizations, and ensuring compliance with confidentiality policies. Expertise in medical terminology, coding systems, and managed care procedures will be vital in facilitating smooth patient care coordination and reimbursement processes.
Responsibilities
  • Obtain insurance-specific prior authorization by submitting necessary documentation and following up diligently.
  • Monitor benefit limits and submit extension requests as needed.
  • Work closely with the billing team on authorization related issues.
  • Verify patient insurance benefits and requirements related to referrals and authorizations.
  • Maintain detailed records of authorization requests, approvals, denials, and appeals.
  • Address and resolve any issues that may arise related to authorizations such as insurance denials, missed appointments or scheduling conflicts.
  • Serve as a liaison between providers, patients, and insurance companies to resolve  authorization issues.
  • Assist patients in understanding their insurance benefits and requirements
  • Ensure compliance with HIPAA regulations and company confidentiality policies
  • Stay informed about changes in health insurance policies, managed care protocols, and medical coding standards relevant to the role.
 Requirements
  • Prior experience working with medical insurance for authorizations and referrals
  • Demonstrated knowledge of health insurance policies, managed care processes, CPT/ICD-10 codes, and insurance verification processes.
  • Proficiency with Microsoft Excel, Word and Outlook
  • Experience utilizing electronic medical records (EMR) management system(s).
  • Self-motivated with strong organizational and multitasking skills
  • Excellent written and verbal communication skills
 
Job Types: Part-time, Full-time
Benefits:
  • 401(k)
  • 401(k) matching
  • Medical/Dental/Vision insurance
  • Life Insurance
  • Short Term Disability Insurance
  • Flexible spending account
  • Paid time off
  • Referral program
Schedule:
  • 8 hour shift
  • Monday to Friday
Experience:
  • 1-2 years (Preferred)
Work Location: Hybrid remote in Pembroke, MA 02359
Top of Form
Application method
  • Email
Require resume
  • Yes
Application updates
  • cwalker@southshoretherapies.com
Candidates contact you (email)
  • Yes, at email address provided

About the Company

S

South Shore Therapies

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