
Medical Claims Examiner
7 days ago
Job Description:
We are seeking an experienced Medical Insurance Specialist to join our team. This role is vital to our operations, supporting sleep studies and DME services.
Key Responsibilities:
- Verify insurance benefits and eligibility for sleep studies, DME, and related procedures.
- Obtain prior authorizations efficiently and accurately.
- Understand and explain co-pays, deductibles, and co-insurance to patients.
- Work with various insurance plans including HMO and PPO.
- Document and track authorizations in EMR systems and Excel.
- Communicate clearly and professionally with patients and insurance companies.
- Support front office and billing teams when needed.
- Handle a high call volume with excellent phone etiquette and attention to detail.
Requirements:
- Minimum 2 years of experience in medical insurance verification and prior authorization.
- Strong knowledge of co-pays, deductibles, co-insurance, and insurance plan types.
- Familiarity with sleep studies and DME services (preferred but not required).
- Ability to multitask, stay organized, and shift roles when necessary.
- Excellent verbal and written communication skills.
- Proficient in EMR systems and Microsoft Office (especially Excel).
- Strong team player with a positive and proactive attitude.
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