Medical Insurance Claim Adjudicator
20 hours ago
This medical insurance verification and prior authorization specialist role is critical to our office operations, supporting both sleep studies and DME services. The ideal candidate will be comfortable multitasking, stepping into different roles as needed, and working in a fast-paced environment.
Key Responsibilities:
- Verify patient 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 high call volumes with excellent phone etiquette and attention to detail.
Required Skills and Qualifications:
- 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.
- Proficiency in EMR systems and Microsoft Office (especially Excel).
- Strong team player with a positive and proactive attitude.
Benefits:
This role offers the opportunity to work in a dynamic team environment, providing excellent customer service and support to patients and insurance companies.
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