Connext is a dedicated team of business process outsourcing experts and innovators, with experience in supporting world-class companies in Title and Escrow, Healthcare, Produce Distribution, Retail and Fashion, Design Consulting, and Finance.
We are currently looking for a Senior Medical Billing Specialist who will be working with Connext's Client in the United States of America
What's in it for you
- Competitive compensation
- Perfect Attendance Bonus
- Life insurance
- HMO Insurance
- Great company culture
- 25% Night Differential
- Annual Increase
What is the job
The Senior Medical Billing Specialist is responsible for conducting insurance verifications and obtaining prior authorizations for a diverse range of therapy services, including Physical Therapy, Occupational Therapy, Speech Therapy, Autism Therapy, and Outpatient Behavioral Health. This role requires a knowledgeable, organized, and professional individual with excellent communication skills to ensure timely processing and compliance with insurance requirements.
Responsibilities:
- Verify patient eligibility and benefits via portal and/or phone call, including collecting referral and authorization requirements, across multiple payers, states, insurance products, and specialties within customer SLAs.
- Work closely with providers to collect accurate patient and medical records and communicate authorization decisions.
- Expediently complete prior authorizations using insurance portals or calling insurers directly.
- Ensure authorization is approved in a timeline manner by following up with insurers and providing additional information.
- Be responsible for handling multiple prior authorizations simultaneously and create process to ensure top of the line performance
- Become a subject matter expert in prior authorization workflows for large insurers
- Communicate effectively across multiple stakeholders
- Maintain strict confidentiality and adhere to HIPAA regulations in handling patient information
Qualifications:
- Minimum of one (1) year experience with medical billing and/or understanding of benefits including deductibles, co-insurance, out of pocket and benefits exclusions.
- Experience in providers software, including Electronic Medical Record Systems (EMR/EHR) and Practice Management Systems (PMS).
- Must have stable employment history.
