The Authorization and Benefits Specialist is responsible for reviewing and processing new referrals; maintaining paper and electronic patient file; verifying patient's benefits and eligibility ; submitting and monitoring insurance prior authorization requests; preparing files for claim submission; actively working with internal customers; collaborating with cross functional departments within the Reimbursement and contracting teams; handling a variety of day to day administrative tasks within the Reimbursement department.

-Follow Electromed mission and core values, while striving to achieve company goals -Understand and adhere to local State and Federal healthcare regulatory and compliance rules -Review new order for patient demographics, insurance information, prescription requirements, and medical records -Verify insurance eligibility and DME benefits -Navigate payer websites -Competently communicate with payers -Effectively submit insurance requests to obtain authorization -Prepare files for claim submission within timely filing limits -Communicate effectively with internal customers such as Patient Care Coordinators, Patient Services Specialists, Customer Support Liaisons and Billing Specialists -Accurately record information to internal Patient Database -Complete other miscellaneous tasks as needed to help support the reimbursement team

Required Skills

High attention to detail and accuracy with the ability to handle multiple priorities Self-starter, highly motivated Ability to grasp new ideas and adapt to new tasks easily Quick learner Natural ability to critically think Work well in a collaborative team environment Excellent written and verbal communication skills Demonstrated exceptional customer service skills Ability to prioritize and organize Strong analytical and problem-solving skills Active participant of continuous improvement

Required Experience

Required:

High School diploma or GED required. 

Minimum of 1 year experience working in a medical setting (eg front desk, patient access, billing office) Experience with typical office equipment Knowledge of Microsoft Office suite (eg Word, Excel, Outlook)

Preferred:

Minimum of 1 year experience working directly with third party or government payers Experience verifying eligibility and benefits with insurance companies from the provider/insurance or DME/HME Understanding of prior authorizations in the DME/HME, clinical or hospital setting Experience with national payers

High attention to detail and accuracy with the ability to handle multiple priorities Self-starter, highly motivated Ability to grasp new ideas and adapt to new tasks easily Quick learner Natural ability to critically think Work well in a collaborative team environment Excellent written and verbal communication skills Demonstrated exceptional customer service skills Ability to prioritize and organize Strong analytical and problem-solving skills Active participant of continuous improvement