Prior Authorization Specialist

Boston O&P • Full-time • $40k - $45k / year • 1w ago

OP Specialty Bracing is growing, and we believe our team is the key to our success. We are hiring a Prior Authorization Specialistto join our team. If you are a motivated, caring individual who wants to make a difference in the lives of children, we encourage you to apply today!

At OP Specialty Bracing, kids are at the heart of everything we do. Our cause is simple: to improve the lives of children with orthopedic conditions and support their families every step of the way. From fractures and clubfoot to cerebral palsy, scoliosis, plagiocephaly, limb loss, and more, our certified clinical team treats the whole child in partnership with their care team. Helping kids is what we do; changing their lives is how we make a difference. OPSB offers specialized pediatric clinics across the country, including in major children’s hospitals, ensuring that every child gets top-notch, kid-focused care.

Our team is constantly developing new, cutting-edge solutions in pediatric orthotics and prosthetics, because we believe every child deserves the very best. At OP Specialty Bracing, pediatric care is not just something we do—it’s our passion, our purpose, and our promise to the kids we serve.

Position Description: Handle all functions related to Patient Billing including verification of insurance, authorization submission, acquisition of all necessary claim documentation. Responsible for all actions relating to delinquent accounts, collections agencies and special adjustments.

Job Responsibilities:

Verify patient Insurance
Submit prior authorization, if needed
Collect all the information necessary to work with insurance claims and patient billing.
Research, administer and resolve any billing discrepancies. Ensure the resolution of any collection’s issues for self-pay balances.
Ensure patient demographic and insurance information is input correctly into the Athena billing system.
Answer patient questions regarding charges.
Understand Copays, Coinsurance, & Deductibles.
Follow Standard Billing procedure
Build proactive relationship with administrative assistants

Requirements:

Strong math and data entry skills.
Knowledge of insurance process, medical terminology and coding.
Knowledge/experience working with billing and payment cycles for medical accounts
Solid experience working with Medicare/Medicaid, private insurance, and insurance verification, authorization and reimbursement
Strong organizational, problem solving and analytical skills.
Proficiency with MS Office (Word, Excel), spreadsheets and medical billing software.

Education/Experience:

High School or associate degree; related experience and/or training.

Benefits Offered for Eligible Employees:

Medical Insurance
Dental Insurance
Vision Insurance
Long & Short-Term Disability
Life Insurance and AD&D
Retirement Savings Plan
Paid Time Off (PTO) & Holidays

Equal Opportunity Employer:

OPSB is proud in its commitment to creating a diverse workforce and providing equal employment opportunities to all employees and applicants for employment without regard to race, color, religion, sex, sexual orientation, gender identity, gender expression, parental status, national origin, age, disability, citizenship status, genetic information or characteristics, marital status, status as a Vietnam era veteran, special disabled veteran, or other protected veteran in accordance with applicable federal, state and local laws, and any other characteristic protected by law.

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