<p>We are seeking a detail-oriented Insurance Authorization Specialist to support timely and accurate insurance verification and prior authorization processes. This role is responsible for reviewing patient and provider information, obtaining required authorizations, confirming coverage, and helping ensure claims are processed efficiently. The ideal candidate has strong knowledge of insurance guidelines, excellent communication skills, and the ability to manage multiple cases in a fast-paced environment.</p><p><br></p><p><strong>Hours: </strong>Monday - Friday 8am -5pm</p><p><br></p><p><strong>Key Responsibilities</strong></p><ul><li>Verify insurance eligibility, benefits, and coverage details</li><li>Obtain prior authorizations and pre-certifications for services, procedures, and medications</li><li>Communicate with insurance carriers, providers, patients, and internal teams regarding authorization requirements and status updates</li><li>Review documentation for completeness and accuracy before submission</li><li>Track authorization requests, approvals, denials, and expirations</li><li>Follow up on pending and denied authorizations and escalate issues as needed</li><li>Maintain accurate records in billing, practice management, or electronic health record systems</li><li>Ensure compliance with payer guidelines, healthcare regulations, and company policies</li><li>Assist with appeals and supporting documentation for denied requests</li><li>Collaborate with clinical, billing, and administrative teams to reduce delays in service and reimbursement</li></ul><p><br></p>
<p>We are seeking a detail-oriented <strong>Medical Charge Entry Specialist</strong> to join our healthcare revenue cycle team. This role is responsible for reviewing, entering, and validating medical charges accurately and efficiently to support timely claims processing and reimbursement. The ideal candidate will have experience with medical billing workflows, strong knowledge of CPT/ICD coding basics, and the ability to work in a fast-paced environment. </p><p><br></p><p><strong>Hours: </strong>Monday - Friday 8am -5pm</p><p><br></p><p><strong>Key Responsibilities:</strong></p><ul><li>Enter patient charges, procedures, and related billing information into the practice management or billing system. </li><li>Review charge tickets, encounter forms, and supporting documentation for completeness and accuracy.</li><li>Verify demographic, insurance, provider, and service information prior to charge submission.</li><li>Identify and resolve charge discrepancies, missing information, and data entry errors. </li><li>Work closely with coders, billers, front office staff, and clinical teams to ensure clean claim submission. </li><li>Maintain productivity and accuracy standards while meeting daily charge entry deadlines. </li><li>Assist with claim edits, denial follow-up support, and account research as needed. </li><li>Ensure compliance with HIPAA, payer guidelines, and internal billing procedures. </li></ul>
<p>obert Half is seeking a detail-oriented <strong>Medical Accounts Receivable (AR) Specialist</strong> for a role focused on claims review, underpayment analysis, and reimbursement resolution. This position is ideal for someone who thrives in a fast-paced environment, enjoys investigative work, and can manage the full lifecycle of claim review from research through resolution.This position is <strong>onsite</strong> but does have the potential to be hybrid following the training period (2 days from home and 3 days onsite)</p><p><br></p><p><strong>Hours</strong>: 7a-930a start time – then work your 8 hours + Flex Time</p><p><br></p><p>Responsibilities include: </p><ul><li>Review, verify, and audit documentation including EOBs, payer contracts, and out-of-state hospital claims to identify underpayments and reimbursement discrepancies.</li><li>Investigate why claims were underpaid and determine the root cause, including payer processing issues or hospital contract load discrepancies.</li><li>Escalate claim issues as needed to support recovery of underpayments owed by insurance carriers.</li><li>Lead the claims review process from initial investigation through final resolution while working with both internal teams and external partners, including hospitals and insurance groups.</li><li>Organize and analyze claim information to ensure complete and efficient processing.</li><li>Manage an assigned portion of client accounts and maintain ownership of claim outcomes.</li><li>Collaborate with team members to identify new ways to leverage internal technology, improve workflows, and create more efficient solutions.</li><li>Bring a fresh perspective to current processes and recommend improvements where appropriate.</li></ul><p><br></p><p><br></p>