Authorizations Specialist Lead

Remote Full-time

Daily Drop — Subscriber Perk

Professional online therapy

Lead the team, take care of yourself. 50% off your first therapy month.

Job Summary:

The Benefits Specialist Lead is responsible for verifying patient insurance coverage, submitting pre-authorizations, and financial assistance support to ensure patients receive coverage for medical and infusion services provided.

Key Responsibilities:

• Verify and document insurance eligibility, benefits, and coverage for all office visits and infusion services.

• Obtains insurance authorization and pre-certification for office visits and infusion services.

• Facilitate insurance denial mitigation steps such as peer-to-peer reviews and appeals.

• Maintains a good working knowledge of infusion drug authorization requirements for all payers, state and federal regulatory guidelines for coverage and authorization.

• Calculate and communicate patient financial responsibility.

• Provide financial assistance support to patients including identifying patient assistance programs and manufacturer copay assistance enrollment.

Qualifications:

• High school diploma or equivalent

• 2-3 years of experience in medical insurance verification and prior authorizations. Experience in infusion services is preferred.

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· Knowledge of insurance terminology, plan types, structures, and approval types

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· Previous experience with J-codes, CPT and ICD-10 coding

• Previous Athena use a plus, but not a requirement

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· Knowledge of medical terminology and clinical documentation review

• Strong organizational skills

• Detail-oriented

• Ability to multi-task and work well in a fast-paced setting

• Critical thinking skills and decisive judgment

We like the way you work it
· no gig iddy
· Gotta bag it up
· no gig iddy ·

We like the way you work it
· no gig iddy
· Gotta bag it up
· no gig iddy ·