Benefits and Authorization Specialist – Specialty Care

🔥 0 minutes ago

🦀 Maryland – Remote

🦀 Maryland – Remote

💵 $18 - $28 / hour

⏰ Full Time

🟢 Junior

🟡 Mid-level

🚫👨‍🎓 No degree required

🦅 H1B Visa Sponsor

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👻 Ghost score 0%

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University of Maryland Faculty Physicians

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

🏥 Healthcare

📚 Education

🧘 Wellness

Healthcare • Education • Wellness

University of Maryland Faculty Physicians is a clinical group practice affiliated with the University of Maryland School of Medicine that provides a wide range of outpatient medical services, including dermatology, cardiology, ophthalmology, urgent care, facial plastic surgery, and medi-spa treatments. The organization operates multiple patient-facing clinics, offers patient portal services (MyChart), appointment scheduling, billing, and partners with the university for clinical education and faculty-led care.

📋 Description

• Verify patient insurance eligibility and benefits for scheduled appointments and procedures • Confirm deductibles, co-pays, coinsurance, and out-of-pocket maximums • Identify in-network and out-of-network benefits across service lines • Accurately document benefit information in the practice management system • Communicate benefit details to office scheduling staff • Communicate demographic errors to appropriate office staff • Obtain prior authorizations for medical and surgical procedures across specialties • Coordinate authorizations for audiology hearing aide services, ENT procedures, facial plastic and reconstructive surgery, full body plastic surgery, ambulatory surgery center services, and physical therapy • Track authorization status and follow up on pending requests • Maintain authorization logs and ensure timely renewals • Collaborate with Billing Specialists, Surgical Coordinators, and Clinical Managers • Stay current on payer policies, coverage guidelines, and authorization requirements • Participate in revenue cycle meetings and process improvement initiatives • Identify and resolve billing complaints and answer questions from staff, patients, and insurance companies • Maintain confidentiality and follow HIPAA guidelines/regulations • Complete special projects as assigned • Attend staff meetings and educational activities

🎯 Requirements

• High school diploma or equivalent • Minimum 2–3 years of experience in medical billing • Strong knowledge of medical insurance plans, including commercial, Medicare, Medicaid, and Tricare • Familiarity with medical terminology and CPT/ICD-10 codes • Experience with practice management systems and EHR platforms • Excellent communication and customer service skills • Knowledge of basic medical coding and third-party operation procedures and practices • Ability to operate a multi-line telephone system • Familiarity with Microsoft applications, including Word and Excel • Strong written and verbal communication skills • Excellent organizational skills and ability to manage multiple tasks • Ability to work as a team player in a cohesive medical practice • Ability to communicate and work well with co-workers • Ability to communicate orally and in writing with internal and external business professionals • Must be responsible, reliable, and able to carry out job functions • Commitment to confidentiality and adherence to HIPAA guidelines/regulations • Ability to ensure departmental adherence to Medicare compliance regulations

🏖️ Benefits

• Total rewards package supporting employees’ life, career and retirement • Educational activities and staff meetings • Professional development through participation in educational activities