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Open nowPosted 613 days ago

Benefits and Authorizations Specialist Lead

Nira Medical17 open roles

Where
Remote
Work mode
Remote
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Your applicationOpen nowBenefits and Authorizations Specialist LeadNira Medical · Remote

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  3. 25 readersRecruiter, hiring manager, skeptic. Round after round.

  4. CV RocketApplied on Nira Medical's own form.

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The clock on this job

Early applications get read.

12.4% of postings close within 7 days. Measured by our own scanner across the market. Nira Medical postings stay open a median of 38 days.

Share of postings closed within
  1. 2.1%1 day
  2. 4.5%3 days
  3. 12.4%7 days
  4. 20.0%14 days
  5. 35.5%30 days
  6. 58.6%60 days
This job: posted 613 days ago

Nira Medical median: 38 days open

The posting

Job Summary: The Benefits Specialist Lead is responsible for verifying patient insurance coverage, submitting pre-authorizations, and financial assistance support to ensure patients receive coverage for medical and infusion services provided.

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.

- Provide financial assistance support to patients including identifying patient assistance programs and manufacturer copay assistance enrollment.

Qualifications:

- 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

- Previous Athena use a plus, but not a requirement

- · Knowledge of medical terminology and clinical documentation review

- Strong organizational skills

- Detail-oriented

- Ability to multi-task and work well in a fast-paced setting

- Critical thinking skills and decisive judgment

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