Benefits and Authorization Specialist

• Verify patient insurance benefits via payer portals and phone outreach
• Conduct detailed benefit verification, including deductibles, out-of-pocket maximums, coverage limitations, and authorization requirements
• Accurately document and communicate benefit details to support billing and patient cost estimates
• Identify and escalate coverage gaps, coordination of benefits issues, or incomplete information
• Assist with intake, review, and uploading of payer documentation into internal systems
• Support prior authorization submissions and follow-ups with payers
• Track pending authorizations to ensure timely resolution
• Maintain accurate records for billing and audit purposes
• Verify accuracy of authorization approvals and responses
• Ensure HIPAA compliance and proper handling of patient information
• Stay up to date on payer and Medicare guidelines

• 2+ years of experience in benefits verification, prior authorization, or health insurance with direct payer interaction
• Bachelor's degree required
• Strong familiarity with payer portals and insurance benefit structures
• High attention to detail and accuracy
• Strong written and verbal communication skills, including payer phone interaction
• Ability to manage multiple priorities in a fast-paced environment
• Proficiency in Microsoft Office
• Ability to work independently and on a team

Experience in durable medical equipment (DME) or specialty medical device reimbursement