
Healthcare Insurance Claims Processor
6 days ago
Medical Insurance Verification and Prior Authorization Specialist.
Job Description:We are seeking a reliable and experienced Medical Insurance Verification & Prior Authorization Specialist to join our team in the Healthcare industry. This role is vital to our operations, supporting sleep studies and DME services.
Our ideal candidate will have a strong understanding of medical insurance plans, including HMO and PPO, as well as experience with EMR systems and Microsoft Office. They will be able to verify insurance benefits and eligibility for sleep studies, DME, and related procedures efficiently and accurately.
The successful candidate will also possess excellent verbal and written communication skills, enabling them to communicate clearly and professionally with patients and insurance companies.
Key Responsibilities:- Verify insurance benefits and eligibility for sleep studies, DME, and related procedures.
- Obtain prior authorizations efficiently and accurately.
- 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.
- 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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