Note: The job is a remote job and is open to candidates in USA. M&D Capital Premier Billing, LLC is seeking an Insurance Authorization & Advocacy Specialist to manage Out of Network authorizations for clients. The role involves ensuring timely submission, accurate documentation, and proactive communication with providers, patients, and insurance companies throughout the authorization process.
Responsibilities
- Monitor new cases and assess GAP eligibility based on insurance coverage
- Manage GAP cases through all processing stages until final determination
- Review insurance policies to identify coverage gaps and strategize for approvals and overturning denials
- Prepare and finalize GAP letters with accurate coding, complete documentation, and strong justification
- Communicate with patients, providers, and insurers to gather information and secure GAP authorization
- Maintain workflow efficiency and delegate tasks to remote team members as needed
- Provide timely updates and weekly case status reports to supervisors and practices
Skills
- Problem Solving: Resourceful, able to identify issues and troubleshoot effectively
- Management & Organization: Strong organizational skills; able to prioritize, handle multiple tasks and maintain smooth workflows
- Communication: Professional and respectful communication with internal teams and external contacts
- Critical Thinking: Quick thinker with sound judgment and common sense
- Self-Motivated & Driven: Works independently, takes initiative, and demonstrates a desire to learn
Benefits
- Health
- Dental
- Vision
- Employee assistance plan
- Paid family leave
- Short-term disability
- Life insurance
- 401(k) plan with employer match
- Flexible spending accounts
- Employee discount program
- Employee referral program
Company Overview
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