Prior Authorization and Billing Specialist

Core Job Duties

• Examine medical records to determine whether procedures, medications, or services require prior authorization.
• Verify patient insurance benefits, eligibility, and coverage details.
• Communicate with healthcare providers, insurance companies, and patients.
• Maintain accurate records of all authorization requests, approvals, denials, and reference numbers and monitor payer portals, follow up on pending requests, and escalate issues as needed.
• Investigate insurance denials, correct errors, resubmit requests, and file appeals.
• Patient Support - Explain authorization processes, delays, and financial implications to patients while maintaining confidentiality.
• Understanding of medical and anatomical terminology
• Ensure all claim documentation is accurate before submission.
• Perform daily billing tasks, including claim generation, posting payments, and posting denials.
• Audit accounts for accuracy, resolve billing discrepancies, and manage accounts receivable.
• Process patient payments, co-pays, and insurance reimbursements.

Additional Administrative Duties:

Register patient demographics and insurance information for procedures.

Handle incoming calls related to pre‑authorization support and bill payments.

All candidates will be cross trained for front desk administrative duties.

Key Skills and Tools

• Proficiency with medical billing software, and payer portals.
• Manage multiple requests and billing cycles with deadlines.
• Strong verbal/written skills for provider, patient, and insurer interactions.
• Resolve denials, policy issues, and claim disputes efficiently.

Full-Time Position Monday - Friday

Competitive Salary & Benefits

Paid Holidays

401K

Please email resume to dermofficemail@gmail.com