Accounts Receivable Insurance Authorization Specialist

Primary Responsibilities

• Resolve billing disputes and discrepancies with customers or third parties.
• Maintain accurate records of all payments received from patients, insurance companies, Medicare, or other payors.
• Follow up on unpaid, denied, or rejected claims and document all actions.
• Cook up and process prior authorizations for hospice services, ensuring all required documentation is submitted to insurance carriers or Medicare.
• Verify patient insurance eligibility and benefits, confirm coverage for ordered services.
• Troubleshoot authorization-related issues in the practice management or billing system.
• Maintain contact management for tracking authorization status and required documentation.
• Work with insurance plans to pre-authorize and re-authorize patient services.
• Review Explanation of Benefits (EOB) and research denials, rejections, or excessive reductions.
• Prepare and submit accurate claims to third-party insurance carriers, either electronically or via hard copy.
• Ensure compliance with healthcare plan requirements and internal billing policies.