Botox/ASC Verification Specialist

***Sign on Bonus for experienced Biller with at least 1 years worth of experience***

$500 paid after 90 days (and another $500 paid after 180 days of successful employment)

Our mission at Advanced Pain Management & Spine Specialists is to serve patients by providing compassionate state-of-the-art pain relief. We strive to provide outstanding patient service with treatment that exceeds the expectations of our patients and our referring physicians. We are looking to add a Botox/ASC Verifications Specialist to our team.

Overview

The Botox/ASC Authorizations position specializes in obtaining payer authorizations for procedures performed by APMSS/PCP, verification of insurance benefits, and insurance collections. A skilled Insurance & Billing Specialist protects the practice from revenue loss and minimizes patient out-of-pocket expenses by ensuring insurance benefits are accurately verified, proper authorizations are obtained, and the practice is reimbursed for all services performed.

Duties

• Verify patient insurance eligibility and benefits for procedures performed in the surgery center, as well as Botox and other injectable procedures performed in office.
• Communicate clearly with patients regarding their insurance coverage, authorization status, and any potential out-of-pocket costs.
• Initiate and manage the prior authorization process for Botox and other injectable procedures, including completing all necessary paperwork and online submissions.
• Appeal denied authorizations, providing necessary documentation and justification to overturn decisions.
• Communicate effectively with insurance companies to obtain authorization approvals, following up on pending requests and resolving any issues or denials.
• Respond to correspondences from insurance carriers.
• Coordinate with specialty pharmacies to ensure all injectable medications are delivered in a timely manner
• Maintain accurate records of all authorization requests, approvals, and denials, utilizing practice management software and other tracking tools.
• Identify and resolve any discrepancies or issues related to patient insurance or authorizations.
• Research, appeal, and resolve all unpaid or denied claims with appropriate insurance carrier.
• Collaborate closely with clinical staff to ensure proper documentation and coding of procedures for authorization purposes.
• Provide regular reports on authorization status, denial rates, and other relevant metrics to management.
• Understand and stay informed of the changes with procedures, billing guidelines, and laws for specific insurance carriers or payers and communicate changes.
• Must be able to work independently and prioritize work on a daily or weekly basis, subject to occasional reprioritization by management.
• Follows all work processes and procedures, while maintaining compliance with the rules and regulations set forth by the company.
• Strives to deliver high-quality results at all times in accordance with standards.
• Protects and keeps all patient and company information confidential.
• Proudly services the company by following all HIPAA, local, state, and federal laws and standards.
• Accepts ownership for all tasks and responsibilities.
• Actively explores new educational pursuits to improve job knowledge and skills.
• May be required to perform duties and responsibilities not listed in this description, on a temporary or long-term basis.

Experience/Qualifications

Education/Training Level:

• Minimum of 1 year of experience in medical billing, insurance verification, or prior authorizations.
• Experience with specific insurance companies commonly used by the practice.
• Strong understanding of insurance policies, procedures, and terminology.

Licenses and Certifications:

• NextGen Experience highly desirable.

Qualifications:

• Exceptional communication abilities both verbally and written.
• Ability to work independently and as part of a team.
• Detail-oriented and able to manage multiple tasks effectively.
• Strong problem-solving and analytical skills.
• Ability to maintain composure and professionalism in dealing with patients and insurance companies.

Technology Skills:

• CPT-4, HCPCS & ICD-10, Medical Terminology, Computer competence
• Proficient with payer websites, practice management software, and electronic health records (EHR) systems

This position offers an opportunity for growth within the organization while contributing to the overall patient experience.

Job Type: Full-time

Pay: From $21.00 per hour

Expected hours: 40 per week

Benefits:

• 401(k)
• 401(k) matching
• Dental insurance
• Health insurance
• Life insurance
• Paid time off
• Vision insurance

Schedule:

• 8 hour shift
• Monday to Friday

Supplemental Pay:

• Signing bonus

Education:

• Associate (Preferred)

Experience:

• Medical billing: 1 year (Preferred)
• Insurance authorization: 1 year (Preferred)

Ability to Commute:

• Fort Myers, FL 33919 (Required)

Ability to Relocate:

• Fort Myers, FL 33919: Relocate before starting work (Required)

Work Location: In person

Salary : $21