Eligibility and Authorization Specialist

Job Summary: Bladder & Bowel Institute is in search of a proactive and detail-oriented Eligibility and Authorization Specialist to join our dedicated team. This role is integral to ensuring patient’s eligibility and authorization requirements are met, and allows BBI to maintain strong, supportive relationships with our patients throughout their healthcare journey.

Key Responsibilities:

· Verify and document insurance eligibility, authorization, and benefits structure of current and potential BBI clients in an accurate and timely manner.

· Monitor the schedule for changes or additions of patients and communicate with clinical team for additional information as needed.

· Review patient medical history to ensure authorization requests meet payer requirements.

· Calculate patient benefit estimates utilizing internal forms and communicate estimates to the clinical support team for delivery to the patient.

· Notify management regarding lack of payer coverage or other service noncoverage issues.

· Access eligibility, authorization, and benefit verification systems via phone, and payor or third-party websites.

· Maintain a comprehensive database of authorization and eligibility resources, and communicate this information with BBI staff, including Outreach, RCM management, and RCM team.

· Display professional, positive, and effective communication with payers, clients, management, and employees.

· Develop knowledge and education to remain current, efficient, and productive as an insurance and payer resource to the business.

· Demonstrate self-direction to prioritize and accomplish job responsibilities.

· Able to work in an environment which may include sudden changes and is able to prioritize tasks to meet authorization requirements.

· Uphold patient confidentiality and rights, ensuring all interactions adhere to BBI’s quality standards.

· Establish and enforce organizational standards to maintain service quality.

Qualifications:

· Associate’s or Bachelor degree required.

· 2 years’ experience in medical billing or insurance authorization is required.

· Demonstrate a strong patient-focused mentality, constantly striving to exceed expectations and build effective relationships.

· Be approachable and empathetic, dedicated to understanding patient needs before acting, and adept at establishing rapport.

· Exhibit excellent prioritization and time management skills, capable of multitasking and shifting focus seamlessly between various tasks.

· Be eager to learn and adapt, with a relentless drive to find solutions to new and existing challenges.

· Be action-oriented, ready to take on challenges with minimal planning, and consistently deliver timely results.

· Be composed and flexible, thriving in a fast-paced and evolving work environment.

· Possess basic computer skills, including proficiency in Microsoft Office, and familiarity with standard office equipment and phone systems.

· Have exceptional phone etiquette and customer service skills.

If you are a self-motivated individual with a passion for healthcare, we encourage you to apply for this exciting opportunity to make a difference in the lives of patients struggling with bladder and bowel control problems.

Job Type: Full-time

Pay: $50,000.00 - $70,000.00 per year

Benefits:

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

People with a criminal record are encouraged to apply

Application Question(s):

• Do you have at least 2 years’ experience in medical billing or insurance authorization?

Work Location: Remote

Salary : $50,000 - $70,000