Nira Medical Group logo
Nira Medical Group

Enabling access to life-changing treatments for neurological care.

Benefits and Authorizations Specialist

Human ResourcesHuman ResourcesFull TimeRemoteSeniorTeam 51-200H1B No SponsorCompany SiteLinkedIn

Location

United States

Posted

1 day ago

Salary

0

Seniority

Senior

High School2.3 yrs expEnglish

Job Description

Benefits and Authorizations Specialist

Nira Medical Group

• Verify and document insurance eligibility, benefits, and coverage for all office visits and infusion services. • Obtains insurance authorization and pre-certification for office visits and infusion services. • Facilitate insurance denial mitigation steps such as peer-to-peer reviews and appeals. • Maintains a good working knowledge of infusion drug authorization requirements for all payers, state and federal regulatory guidelines for coverage and authorization. • Calculate and communicate patient financial responsibility. • Provide financial assistance support to patients including identifying patient assistance programs and manufacturer copay assistance enrollment.

Job Requirements

  • High school diploma or equivalent
  • 2-3 years of experience in medical insurance verification and prior authorizations. Experience in infusion services is preferred.
  • Knowledge of insurance terminology, plan types, structures, and approval types
  • Previous experience with J-codes, CPT and ICD-10 coding
  • Previous Athena use a plus, but not a requirement
  • Knowledge of medical terminology and clinical documentation review
  • Strong organizational skills
  • Detail-oriented
  • Ability to multi-task and work well in a fast-paced setting
  • Critical thinking skills and decisive judgment

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