Billing & Authorization Specialist

QRM is seeking a Billing and Authorization Specialist focuses on obtaining Verification of Benefits and authorizations and or billing claims timely and following billing protocols for each client. For the billing role the duties include all collection follow up to endure timely collections for each claim. For the VOB and authorizations the duties include obtaining the information and communicating that to the client. The Billing and Authorization Specialist reports to the Billing and Authorization Manager.  This is a hybrid position in our Addison, TX office (most weeks will consist of 3 in-office days  - there may be occasions when more time in-office time is required)

Key Results Area  

Learning AR and clearinghouse systems for each client 

Billing all claims to appropriate insurance companies following each client’s SOP’s 

Contacting insurance companies to obtain status of claims 

Filing appeals and disputes with insurance companies to obtain correct payments. 

Ability to handle large caseload of authorizations, billing and claims follow up daily/weekly 

Enter all benefits verifications and authorizations into the proper system 

Work within insurance company portals 

Communicate findings to the clients in a timely manner Follow up on outstanding issues in a timely manner 

Ability to work complex aging reports 

Provides excellent customer service and human relations within the department as well as with other departments, providers, members and other external sources 

Maintain patient confidentiality and information security 

Assists with audits 

Enters managed care authorization information into the rehab EMR 

Evaluate and assess personal performance on a routine basis 

Other duties as assigned 

High school degree or equivalent 

Microsoft Office proficiency, with the aptitude to learn new programs 

Independent and self-motivated 

Ability to provide information in a concise manner 

Innovative and detail-oriented professional with strong analytical and organizational skills 

Strong proactive written and verbal communication supporting client satisfaction and retention 

Solid collaborative skills with team and clients with the ability to work remotely and autonomously 

Strong time management with a proven ability to meet deadlines 

Function well in a fast-paced and at times stressful environment 

Demonstrate discretion, sensitivity, and ability to maintain client confidentiality 

Ability to establish and maintain positive relationships 

Strong written and verbal communication supporting client satisfaction and retention 

Experience in verifying benefits and obtaining prior authorizations Working Conditions 

Works in well-lighted/ventilated office, and as indicated remotely in a professional environment 

Must be able to remain in a stationary position and move about the work area intermittently throughout the workday 

Ability to observe details at close range 

Constantly operates a computer and other office equipment 

Ability to communicate and exchange information and ideas so others will understand