Specialist, Benefits Eligibility and Authorizations

Cardinal Health•Doral, FL

1d•$20 - $26•Onsite

About The Position

Benefits Eligibility and Authorization verify patient specific health benefits. Benefits Eligibility and Authorization provides services to customers relating to medical billing, medical reimbursement, and/or other services by acting as a liaison in problem-solving, research and problem/dispute resolution.

Requirements

Bachelor's degree in related field, or equivalent work experience, preferred
3+ year experience in DME, healthcare revenue cycle management, insurance verification, or prior authorization preferred.
Knowledge of Medicare, Medicaid, and commercial payer requirements preferred
Strong analytical, problem-solving, and communication skills.
Ability to interpret payer policies and explain coverage requirements.
Proficiency with EMR, billing systems, and denial management tools.

Responsibilities

Identifies and investigates claim denials and rejections related to insurance eligibility, benefits verification, and prior authorization requirements for Durable Medical Equipment (DME) servies.
Review and resolve claim denials and rejections related to eligibility, coverage, coordination of benefits, and authorization issues.
Verify patient insurance coverage, benefits, and payer requirements.
Obtain, update, and track prior authorizations and reauthorizations.
Analyze denial trends and identify root causes to prevent future claim issues.
Correct registration, insurance, and authorization errors within billing and practice management systems.
Ensure compliance with payer policies, Medicare guidelines, and company procedures.
Document all account activity accurately and maintain productivity and quality standards.
Collaborate with intake, billing, and revenue cycle teams to improve front-end processes and reduce preventable denials.