Insurance Authorization Specialist

Insurance Authorization Specialist – 30 to 40 hrs Pay: $22-$24/hr South Shore Therapies, a premier pediatric OT and Speech practice, is seeking an Insurance Authorization Specialist to join our billing and authorization administration team. The ideal candidate will possess an understanding of health insurance policies, medical billing, and authorization processes. In this role, you will be responsible for verifying insurance benefit coverage, obtaining prior authorizations, and ensuring compliance with confidentiality policies. Expertise in medical terminology, coding systems, and managed care procedures will be vital in facilitating smooth patient care coordination and reimbursement processes. Responsibilities Obtain insurance-specific prior authorization by submitting necessary documentation and following up diligently. Monitor benefit limits and submit extension requests as needed. Work closely with the billing team on authorization related issues. Verify patient insurance benefits and requirements related to referrals and authorizations. Maintain detailed records of authorization requests, approvals, denials, and appeals. Address and resolve any issues that may arise related to authorizations such as insurance denials, missed appointments or scheduling conflicts. Serve as a liaison between providers, patients, and insurance companies to resolve authorization issues. Assist patients in understanding their insurance benefits and requirements. Ensure compliance with HIPAA regulations and company confidentiality policies. Stay informed about changes in health insurance policies, managed care protocols, and medical coding standards relevant to the role. Requirements Prior experience working with medical insurance for authorizations and referrals. Demonstrated knowledge of health insurance policies, managed care processes, CPT/ICD-10 codes, and insurance verification processes. Proficiency with Microsoft Excel, Word and Outlook. Experience utilizing electronic medical records (EMR) management system(s). Self‑motivated with strong organizational and multitasking skills. Excellent written and verbal communication skills. Job Types Part‑time Full‑time Benefits 401(k) 401(k) matching Life Insurance Short Term Disability Insurance Flexible spending account Paid time off Referral program Schedule 8 hour shift Monday to Friday Experience 1‑2 years (Preferred) Work Location Hybrid remote in Pembroke, MA 02359 #J-18808-Ljbffr