Internal Number : 7562

Why Beebe?

Become part of the Beebe team - an inclusive team positioned in a vibrant, coastal community. Enjoy a fulfilling career as you support the health of our patients and a team focused on excellence.

In addition to competitive compensation and wellness benefits (medical, dental, vision, and prescription) Beebe Healthcare also offers :

• Sign-on and Referral Bonuses for select positions
• Tuition Assistance up to $5,000
• Paid Time Off
• Long Term Sick accrual
• Employer Contribution Plan
• Zero copay for drugs on prescription plan for certain conditions
• College Bound 529 Savings Plan
• Life Insurance
• Beebe Pers via WorkAdvantage
• Employee Assistance Program
• Pet Insurance

Overview

We are seeking a meticulous and proactive Insurance Authorization Specialist to join our healthcare team. The Insurance Authorization Specialist is responsible for obtaining and verifying insurance coverage and prior authorizations for patient services.

This role ensures that all necessary approvals are secured to facilitate patient care and optimize reimbursement.

Responsibilities

Insurance VerificationVerify patient insurance coverage and benefits using electronic systems and direct communication with insurance carriers.

Update patient insurance information in the electronic health record (EHR) system

Authorization RequestsSubmit prior authorization requests for medical procedures, treatments, and medications as required by insurance plans.

Follow up on pending authorizations and appeals, ensuring timely resolution

Documentation and CommunicationMaintain accurate and detailed records of all insurance authorizations, denials, and appeals.

Communicate authorization status to patients, providers, and other relevant staff.Collaborate with clinical and administrative staff to gather necessary documentation for authorization requests.

• Denials ManagementReview and analyze authorization denials to determine reasons and necessary actions.Prepare and submit appeal documentation to insurance carriers when necessary.
• Policy ComplianceStay current with insurance plan requirements, authorization policies, and regulatory guidelines.Ensure compliance with HIPAA and other privacy regulations.

Qualifications

• Minimum of 1-2 years of experience in insurance authorization, medical billing, or a related field in a healthcare setting.
• Familiarity with insurance plans, medical terminology, and authorization processes.
• Strong understanding of health insurance plans, including HMOs, PPOs, Medicare, and Medicaid.
• Excellent organizational and time-management skills.
• Attention to detail and accuracy in data entry and documentation.
• Effective communication and interpersonal skills.
• Ability to work independently and as part of a team.
• Proficiency in using EHR systems and insurance verification tools.
• Problem-solving skills to address authorization and denial issues.

Competencies Skills

• Clear Communication Skills Both Written And Verbal
• Able To Keep Confidential Information Regarding Patients, Team Members
• Able To Withstand Crisis Situations
• Has Skills To Provides Customer Service To Patients, Team Members And Visitors
• Knowledge And Experience With Electronic Health Records

Credentials

Certification in medical billing and coding (e.g., CPC, CCA, CCS) is a plus

Education

• High school graduate or equivalent
• Associate's or Bachelor’s degree in healthcare administration or related field preferred.

Salaries starting at

USD $17.50 / Hr.

Last updated : 2024-05-30