Insurance Specialist - Prior Authorization (Remote) - Eastern & Central Timezones

About Us: 

Meduit is a national leader in healthcare revenue cycle management, supporting hospitals and physician practices in 48 states. We focus on optimizing payments, allowing clients to focus on patient care, and pride ourselves on our core values: Integrity, Teamwork, Continuous Improvement, Client-Focused, and Results-Oriented. Learn more at www.meduitrcm.com. 

About the Role: 

Insurance Specialists are highly focused on the resolution of insurance processing errors and denials and work to resolve hospital and physician billing challenges. You will utilize your expertise in patient billing, claims submission, and payer guidelines (Medicare, Medicaid, &, commercial insurers) to effectively work with insurance companies, resolve issues, and ensure accurate and timely payments.

Key Responsibilities: 

Reduce outstanding accounts receivable by managing claims inventory 

Speak to patients and insurance companies in a professional manner regarding their outstanding balances 

Gather information from patients, clients/family members, client clinical areas, government agencies, employers, third party payors and/or medical payment programs, etc. both in-person and by telephone to register patients, gather or update information, obtain referrals and pre-authorizations, complete appropriate forms, conduct evaluations, determine benefits and eligibility (insurance, public programs, etc.), determine financial responsibility and/or to identify sources of payment for services 

Request, input, verify, and modify patient’s demographic, primary care provider, and payor information 

Provide excellent customer service and timely response to questions and issues related to benefits, billing, claims, payments, etc. 

Answer questions by phone and provide quotes for services; identify financial resources, etc. in accordance with the client policies and procedures 

Utilize various databases and specialized computer software for revenue cycle activities including eligibility verifications, pre-authorizations, medical necessity, review/updating of patient accounts, etc. 

Explain charges, answer questions, and communicate a variety of requirements, policies, and procedures regarding patient financial care services and resources to patients, staff, payors, and agencies 

Work with Claims and Collections in order to assist patients and their families with billing and payment activities

Skills & Competencies: 

Integrity

Communication

Problem-solving

Teamwork

Required Qualifications: 

High School Diploma/GED

2+ years of Denials Management experience 

2+ years Medical Billing/Follow-up experience  

Medicare, Medicaid, and commercial payor experience

Experience with WC Pre-Access

Proficiency with PC-based applications (Microsoft Outlook, Word, and Excel)

Download speed of 30MB or higher & upload speed of 10MB or higher are REQUIRED. (you can test your speed here: https://speedtest.net/)

Access to a Secure and Private workspace (a space in which no one can hear or see you as you may have protected health information on your screen or you may say names, social security numbers or other PHI)

Employment eligibility: 

Must be legally authorized to work in the United States without sponsorship

As a condition of employment, a pre-employment background check will be conducted

At this time, we are unable to consider candidates residing in the state of New York for this position

What We Offer: 

Comprehensive paid training 

Medical, dental, and vision insurance 

HSA and FSA available 

401(k) with company match 

Paid Wellness Time and Holidays 

Employer paid life insurance and long-term disability 

Internal growth opportunities 

Meduit is an Equal Opportunity Employer. We do not discriminate based on any protected class and welcome applicants from all backgrounds, consistent with applicable laws. Employment is contingent upon successful completion of a background check, satisfactory references, and any required documentation. 

Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions of this position. 

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