Benefits and Authorizations Specialist

Nira Medical
United States
Workplace: RemoteFull timeFunction: Healthcare (Clinical, Medical, Wellness)Experience: 2-3 yearsEducation: high_schoolSkills: ["Organization","Detail-oriented","Multi-tasking","Critical thinking","Communication"]

The Benefits Specialist verifies patient insurance coverage, submits pre-authorizations, and coordinates financial assistance to ensure patients receive coverage for medical and infusion services. Works with payers to review eligibility, handles denials, and communicates patient financial responsibility, guiding patients through assistance programs in a fast-paced infusion and revenue cycle team.

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FursaFursa
Nira Medical
Nira Medical
1 year ago

Benefits and Authorizations Specialist

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Last checked: 6 minutes agoStatus: Live

Job Summary

The Benefits Specialist verifies patient insurance coverage, submits pre-authorizations, and coordinates financial assistance to ensure patients receive coverage for medical and infusion services. Works with payers to review eligibility, handles denials, and communicates patient financial responsibility, guiding patients through assistance programs in a fast-paced infusion and revenue cycle team.
Location: United States
Workplace: Remote
Employment Type: Full time
Job Function: Healthcare (Clinical, Medical, Wellness)

Key Responsibilities

  • •Verify and document insurance eligibility, benefits, and coverage for all office visits and infusion services.
  • •Obtains insurance authorization and pre-certification for office visits and infusion services.
  • •Facilitate insurance denial mitigation steps such as peer-to-peer reviews and appeals.
  • •Maintains a good working knowledge of infusion drug authorization requirements for all payers, state and federal regulatory guidelines for coverage and authorization.
  • •Calculate and communicate patient financial responsibility.

Key Requirements

  • •High school diploma or equivalent
  • •2-3 years of experience in medical insurance verification and prior authorizations. Experience in infusion services is preferred
  • •Knowledge of insurance terminology, plan types, structures, and approval types
  • •Previous experience with J-codes, CPT and ICD-10 coding
  • •Knowledge of medical terminology and clinical documentation review
Experience:2-3 yearsHealthcareMedical insuranceInfusion services
Education:High School
Skills:OrganizationDetail-orientedMulti-taskingCritical thinkingCommunication
Tech Stack:J-codesCPTICD-10Athena

Company Brief

Nira Medical
Nira Medical is a national neurology practice platform that partners with independent clinics to expand access to neurological care, infusion services, and clinical research, and to build real-world data resources for conditions like multiple sclerosis.
Industry: Healthcare Providers
Company Size: Medium (51 to 250 employees)
Headquarters: New York, United States
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