About the position
Medix Infusion is seeking a dedicated and detail-oriented Medical Insurance Verification Specialist to join our team. As a Medical Insurance Specialist, you will verify insurance eligibility and benefits for infusion services, review medical necessity guidelines, and ensure accurate documentation. You will also handle authorization, predetermination, and appeal requests, collaborating with Intake, Scheduling, Pharmacy, and Clinical departments to manage patient care efficiently. This is an onsite role at our corporate office, open Monday through Friday, from 8:00 AM to 8:00 PM. You’ll be part of a supportive, close-knit team in a dynamic, fast-paced environment that is deeply focused on delivering exceptional, patient-centered care. Medix Infusion is a technology-driven healthcare platform enhancing patient care and access to infusion therapies, specializing in disease management and infusion pharmacy services for chronic and acutely ill patients, especially in underserved communities. We offer personalized home and in-suite infusion therapies, ensuring convenience and comfort. Our expert team provides a comprehensive range of treatments, including anti-infectives, biologics, IVIG, and other injectables, making each patient’s journey as smooth as possible.
Responsibilities
- Verify insurance eligibility and benefits via phone, fax, or payer portals.
- Ensure timely completion of insurance reviews and documentation in the EMR system.
- Review payer medical policies to confirm medical necessity, including Medicare and FDA guidelines.
- Obtain necessary documentation from medical providers to support medical necessity.
- Submit and follow up on appeal requests for denied authorizations.
- Coordinate with departments to prevent delays in patient care.
- Assist in training staff and attend departmental meetings as needed.
Requirements
- High School Diploma or equivalent.
- 2-3 years of experience in healthcare, pharmacy, or medical claims billing and coding, including prior authorization and appeals.
- 1 years of infusion experience preferred.
- Strong understanding of Medicare, Medicaid, and commercial payer policies.
- Excellent communication skills and attention to detail.
- Ability to work effectively in high-volume, quality-focused teams.
Benefits
- Health and life insurance, voluntary dental/vision insurance.
- 401(k) plan with company contributions.
- Paid holidays and vacation time.
