Medical Billing and Insurance Eligibility Coordinator
2 days ago
We are currently seeking an experienced Eligibility and Authorization Specialist to join our front-end medical billing team.
This role is focused on insurance eligibility verification, benefits management, and prior authorization coordination. As a key member of our team, you will be responsible for verifying patient eligibility, managing benefit coverage, and ensuring timely approval of medical procedures.
Responsibilities:- Verify insurance eligibility and benefit coverage using payer websites and clearinghouse portals.
- Communicate with insurance carriers via phone or online systems to confirm patient benefits and pre-authorization requirements.
- Prepare and submit prior authorization requests to payers based on scheduled procedures and clinical documentation.
- Track and follow up on pending authorizations to ensure timely approvals.
- Maintain organized records of all eligibility checks and authorization requests.
- Escalate complex cases or delays to supervisors with proper documentation.
- 1–2 years of experience in U.S. medical billing, eligibility verification, or prior authorization.
- Knowledge of commercial payers, Medicare, and Medicaid requirements.
- Familiarity with tools like Availity, payer portals, and EHR systems.
- Strong communication skills and fluency in English (written and spoken).
- Excellent attention to detail and ability to manage time-sensitive tasks.
- Insurance eligibility verification.
- Prior authorization management.
- Communication and negotiation skills.
- Time management and organization.
- Competitive salary and benefits package.
- Opportunities for career growth and professional development.
- Collaborative and dynamic work environment.
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