Benefits and Authorization Specialist (Chesapeake (Specialty Care)

University of Maryland Emergency Medicine•Baltimore, MD

5d•$39,500 - $59,300•Onsite

About The Position

The Benefits Coordinator/Authorization Specialist serves as a vital link between insurance companies and clinical staff. This position is responsible for verifying patient insurance benefits, obtaining prior authorizations, and communicating information to the appropriate office personnel. The Benefits Coordinator/Authorization Specialist plays a key role in the revenue cycle by ensuring accurate benefit information is captured upfront to minimize claim denials and patient billing surprises.

Requirements

High school diploma or equivalent
Minimum 2-3 years of experience in medical billing
Strong knowledge of medical insurance plans (commercial, Medicare, Medicaid, Tricare)
Familiarity with medical terminology and CPT/ICD-10 codes
Experience with practice management systems and EHR platforms
Excellent communication and customer service skills
Knowledge of basic medical coding and third-party operation procedures and practices
Ability to operate a multi-line telephone system and answer a telephone in a pleasant and helpful manner
Familiarity with Microsoft applications, including, but not limited to Word and Excel
Strong written and verbal communication skills including the ability to confidently speak to patients
Excellent organizational skills to manage multiple tasks throughout the day
Demonstrate the ability to work as a team player in a very cohesive medical practice
Ability to communicate and work well with co-workers. Open and honest communication
Ability to effectively communicate orally and in writing with internal and external business professionals
Must be responsible, reliable, and able to carry out job functions

Responsibilities

Verify patient insurance eligibility and benefits for all scheduled appointments and procedures
Confirm coverage details including deductibles, co-pays, coinsurance, and out-of-pocket maximums
Identify in-network vs. out-of-network benefits across all service lines
Document benefit information accurately in the practice management system
Communicate benefit details to office scheduling staff
Communicate any Demographic errors with appropriate office staff
Obtain prior authorizations for medical and surgical procedures across all specialties
Coordinate authorizations for specialty services including: Audiology Hearing Aide services, ENT procedures (sinus surgery, tonsillectomy, septoplasty, etc.), Facial plastic and reconstructive surgery, Full body plastic surgery (cosmetic vs. reconstructive determinations), Practice owned Ambulatory Surgery Center (ASC) facility, Physical Therapy for Fyzical Balance Centers
Track authorization status and follow up on pending requests
Maintain authorization logs and ensure timely renewals
Work closely with Billing Specialists, Surgical Coordinators, and Clinical Managers
Stay current on payer policies, coverage guidelines, and authorization requirements
Participate in revenue cycle meetings and process improvement initiatives
Identify and resolve billing complaints, answer questions from staff, patients and insurance companies
Ensure departmental adherence to Medicare compliance regulations
Maintain the strictest confidentiality; adhere to all HIPAA guidelines/regulations
Successful completion of special projects as assigned
Participate in educational activities and attend staff meetings