Insurance Authorization Rep

Insurance Authorization Representative - Remote Blue Cloud is the largest pediatric ambulatory surgery center (ASC) company in the country, specializing in dental restorative and exodontia surgery for pediatric and special‑needs patients delivered under general anesthesia. We are a mission‑driven company focused on safe, high‑quality, and accessible care at reduced costs to families and payors. Overview As part of our growing ASCs, we are seeking a Patient Service Coordinator to support our clinical team of dentists, anesthesiologists, registered nurses, and dental assistants. Responsibilities Perform insurance verification and authorizations. Engage in heavy phone contact with dental and medical insurance companies to address CPT/CDT code discrepancies. Contact patients prior to appointments regarding any insurance or authorization issues. Provide patients with pertinent information regarding coverage. Essential Functions Accurately enter insurance information into the computer system. Pre‑certification/authorization and insurance verification for all patients. Obtain prior authorization for procedures. Research, follow up, and resolve open & pending authorizations in a timely manner. Calculate cash estimates for patients on upcoming visits/procedures. Contact patients regarding financial obligations and arrange payments. Document activity in patient accounts. Maintain clear and concise documentation of all information. Communicate with patients and insurance companies while maintaining strict confidentiality. Scan medical documents into patient accounts. Answer questions from clinics, patients, insurance companies, and staff. Adhere to HIPAA guidelines and regulations. Perform tasks based on a set schedule and complete general office duties as needed. Competencies Customer/Client Focus Stress Management/Composure Results Driven Technical Capacity Problem Solving/Analysis Teamwork Orientation Collaboration Skills Time Management Communication Proficiency Requirements High School Diploma or Equivalent. Ability to handle multiple responsibilities simultaneously in a deadline‑driven environment. Strong understanding of benefits investigation: deductibles, co‑insurance, out‑of‑pocket expense, and benefit exclusions. Preferred Qualifications Associate’s degree. Additional coursework in medical/dental billing. Previous experience with medical/dental billing software systems. 3–5 years in a fast‑paced medical/dental office environment. Knowledge of patient registration, scheduling, authorizations, billing, and dental/medical policies. Working knowledge of Medicare, Medicaid, BC/BS, Workers Compensation, Managed Care, and commercial insurance billing regulations. Strong organization, problem‑solving, and communication skills. Experience Insurance verification: 1 year (Preferred). Medical billing: 1 year (Preferred). Work Location Remote opportunity in AZ, ID, TN, MO, TX, MD, CO, FL, DE, IL, KS, MI, NV, NC, OH, PA, WV. (Not eligible for CA employees.) Position Type & Hours Full‑time, day shift. Monday through Friday with occasional overtime. 40 hours per week. Benefits 401(k) Dental insurance Health insurance Life insurance Paid time off Vision insurance $18‑20 per hour EEO Statement Blue Cloud is an equal‑opportunity employer. Consistent with applicable law, all qualified applicants will receive consideration for employment without regard to age, ancestry, citizenship, color, family or medical care leave, gender identity or expression, genetic information, immigration status, marital status, medical condition, national origin, physical or mental disability, political affiliation, protected veteran or military status, race, ethnicity, religion, sex (including pregnancy), sexual orientation, or any other characteristic protected by applicable local laws, regulations, and ordinances. #J-18808-Ljbffr Blue Cloud Pediatric Surgery Centers