PRP Authorization Specialist Maryland Medicaid
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IOU Billing Services
US
Summary
The Authorization Specialist manages prior authorizations and pre-certifications while verifying patient insurance eligibility and benefits. They also communicate with insurance carriers and providers to resolve claim denials and ensure accurate documentation.
Job Description
Benefits:
- 401(k)
- 401(k) matching
- Bonus based on performance
- Competitive salary
- Dental insurance
- Health insurance
- Paid time off
- Vision insurance
About the Role:IOU Billing Services in Montgomery, NY is looking for a detail-oriented Authorization Specialist to join their growing team! In this critical role, you'll be at the heart of the billing process, ensuring accurate and timely authorizations that keep operations running smoothly for Maryland Medicaid. Experience Required. If you thrive in a fast-paced environment and have a passion for precision, this is the opportunity for you.
Responsibilities:
- Process and manage prior authorizations and pre-certifications in a timely manner
- Verify patient insurance eligibility and benefits to ensure coverage accuracy
- Communicate with insurance carriers, providers, and clinical staff to obtain necessary approvals
- Track and follow up on pending authorizations to prevent delays in service
- Maintain accurate documentation of authorization requests, approvals, and denials
- Review and interpret payer-specific authorization requirements and guidelines
- Support the billing team by resolving authorization-related claim denials and discrepancies
Requirements:
- 5+ years of experience in medical billing, prior authorization, or insurance verification for PRP Maryland Medicaid required.
- Familiarity with ICD-10, CPT codes, and medical terminology
- Experience working with insurance portals and electronic health record (EHR) systems
- Strong attention to detail and ability to manage multiple tasks simultaneously
- Excellent communication skills for interacting with payers, providers, and patients
- Knowledge of payer authorization requirements and managed care guidelines
- Experience in Icanotes EHR, Waystar, Inovalon, Availity and Carelon Provider Connect
About Us:IOU Billing Services is a trusted billing and revenue cycle management company based in Montgomery, NY, dedicated to helping healthcare providers maximize reimbursements and streamline their billing processes. Our clients rely on us for our expertise, accuracy, and commitment to results. Our team enjoys a collaborative and supportive work environment where every employee plays a meaningful role in the company's success.
This is a remote position.
