Insurance Authorization & Billing Representative  

Homes4Hope is currently seeking an Insurance Authorization and Billing Representative for our busy outpatient office.

Work Location: In-person, Salisbury, MD office

The Homes4Hope organization was developed in 2017 with their first recovery house in Salisbury MD.  Within 5 years the organization grew to include: two ASAM 3.1 Low Intensity Residential Treatment programs, two level II recovery houses and an outpatient facility providing mental health, substance use counseling, and medication management (coming soon).  Throughout the growth of the organization, Homes4Hope is steadfast in its commitment to provide the best care possible for their clients in a calming homelike environment.

The Insurance Authorization & Billing Representative must have at least 1-2 years of experience in insurance authorization, medical billing, or a related field in a healthcare setting, as well as familiarity with insurance plans, medical terminology, authorization processes, and a strong understanding of health insurance plans, including HMO’s, PPO’s, Medicare & Medicaid. The right candidate will also have excellent organizational and time management skills, attention to detail, accuracy in data entry and effective communication and interpersonal skills.  

Primary duties include:

•     Insurance verification

·         Verify patient insurance coverage and benefits using electronic systems and direct communication with insurance carriers

·         Update patient insurance information in the electronic health record (EHR) system

•      Authorization Requests

·         Submit prior authorization requests for medical procedures, treatments, and medications as required by insurance plans

·         Follow up on pending authorizations and appeals, ensuring timely resolution

·         Documentation and communication

·         Maintain accurate and detailed records of all insurance authorizations, denials and appeals

·         Communicate authorization status to patients, providers, and other relevant staff

·         Collaborate with clinical and administrative staff to gather necessary documentation for authorization requests

·         Denials management

·         Review and analyze authorization denials to determine reasons and necessary actions

·         Prepare and submit appeal documentation to insurance carriers when necessary

·         Policy compliance

·         Stay current with insurance plan requirements, authorization policies, and regulatory guidelines

Pay Range: $17 - $24 per hour, depending on qualifications.

Education: High school diploma or equivalent.

Must have a valid driver’s license.

Homes4Hope is an equal opportunity employer, and all qualified applicants will receive consideration for employment without regard to race, color, religion, age, disability status, gender, sexual orientation, ancestry, protected veteran status, national origin, genetic information or any other legally protected status.