Medical Billing & Prior Authorization Specialist

Job Title: Medical Billing & Prior Authorization Specialist Position Type: Full-Time Work Hours: 9:00 AM – 6:00 PM Central Time (with 1-hour unpaid lunch break) Work Days: Monday – Friday Weekend Availability: 1–2 hours on weekends, only as needed (Saturday and Sunday, around 1:00 PM Central Time, 1 hour each for follow-ups) Salary: $5–7 per hour, depending on experience Workplace: Remote Preferred Candidate Location: Philippines About the Role Our Client is looking for an experienced and detail-oriented Medical Billing & Prior Authorization Specialist to join a well-established, US-based psychology and psychiatry practice. The clinic provides comprehensive mental and behavioral healthcare services, including psychotherapy, psychological evaluations, neurofeedback, and Transcranial Magnetic Stimulation (TMS). With approximately six providers serving 30–50 patients daily, the practice is committed to delivering quality patient care while maintaining efficient administrative and billing operations. The ideal candidate has hands-on experience with US healthcare insurance billing, claims processing, and prior authorizations. You will initially support the clinic's billing operations, including covering responsibilities during an existing team member's maternity leave, before transitioning into a long-term collaborative billing role. This opportunity is ideal for someone who is organized, proactive, comfortable communicating with insurance companies and patients, and interested in growing within a healthcare practice. Key Responsibilities Medical Billing & Insurance Claims Processing (Top Priority) Manage and process approximately 20–30 US healthcare insurance claims daily, ensuring accurate and timely submissions. Review billing information, insurance coverage, provider details, and documentation before submitting claims. Identify and resolve billing discrepancies, rejected claims, and processing issues. Ensure accurate billing for services involving psychologists, psychiatrists, and doctoral interns, following applicable payer requirements. Coordinate with insurance companies to resolve claims-related concerns and maintain proper reimbursement workflows. Prior Authorization Management Handle prior authorization requests for applicable behavioral health and psychiatric services. Verify insurance requirements, coverage limitations, and authorization status. Coordinate with providers, insurance companies, and internal staff to obtain necessary documentation....

Summary and match are AI-generated; verify details on the original posting.

Listed via Himalayas. All sources