Insurance Verification & Authorization Specialist - Orthotics & Prosthetics

$37,440 - $41,600/Yr

Elizur - Pittsburgh, PA

Full-time - Entry Level

Pittsburgh, PA

Merchant Wholesalers, Durable Goods

About the position

The Insurance Verification & Authorization Specialist at ēlizur plays a crucial role in supporting patients who require specialized orthotic and prosthetic medical devices. This position focuses on managing insurance verification and prior authorizations, ensuring a seamless experience for clients while providing exceptional customer service. The specialist will work closely with patients and healthcare providers to facilitate the necessary documentation and approvals for medical devices, contributing to improved patient outcomes.

Responsibilities

• Manage high-volume insurance verification and prior authorizations.
• Verify insurance benefits and coverage for specific O&P devices.
• Accurately enter the insurance carrier, patient identification, and eligibility information in the patient's account.
• Obtain necessary clinical documentation required to justify the medical need for the O&P product being provided.
• Prepare and submit authorization and pre-cert requests as needed based on insurance medical policy requirements.
• Follow through on any open & pending authorizations based on the steps outlined in the follow-up process.
• Contact patients to review their insurance coverage, out-of-pocket details, and any updates on their order process while maintaining a positive, empathetic, and professional attitude towards all ēlizur customers.
• Upload medical documents and notate all correspondence into the patient's chart.
• Participate in continual educational training on a regular basis to maintain knowledge and competency in the payor medical policies.

Requirements

• At least 1 year of customer service experience in the healthcare industry is preferred.
• Insurance knowledge, verification, and portal navigation is required.
• Experience in a healthcare environment.
• Strong customer service background.
• Computer literacy skills.
• Excellent verbal and written communication skills.
• Ability to handle outbound calling and insurance portal navigation.
• Proficiency in data entry and notations in EMR systems.
• Proven time management, organizational skills, multi-tasking, prioritization, and follow-up skills in a rapidly changing environment.
• Ability to work independently while being a productive member of the team.

Benefits

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