Nira Medical ยท 2 months ago
Benefits and Authorizations Specialist
United States
Full-time
Remote
Entry Level
2+ years expNira Medical is a healthcare provider focused on ensuring patients receive necessary medical and infusion services. The Benefits and Authorizations Specialist is responsible for verifying insurance coverage, obtaining pre-authorizations, and providing financial assistance support to patients.
Health CareHospitalMedical
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
Qualification
Required
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
Strong organizational skills
Detail-oriented
Ability to multi-task and work well in a fast-paced setting
Critical thinking skills and decisive judgment
Preferred
Experience in infusion services
Previous Athena use a plus, but not a requirement
Company
Nira Medical
Nira Medical is a healthcare company focused on advancing outpatient neurological care.
51-200 employees
Funding
Current Stage
Growth StageCompany data provided by crunchbase