We are seeking a highly motivated and detail-oriented Authorization and Denials Specialist to join a dynamic medical billing team. In this role, you will manage prior authorization requests, review claim denials, and work to ensure timely resolution of billing issues. Your work will help optimize revenue cycles, improve patient satisfaction, and support compliance with healthcare regulations.

Review and process prior authorization requests for medical procedures and services, ensuring documentation is complete and accurate.
Analyze claim denials related to authorization issues, coding discrepancies, or documentation deficiencies, and develop efficient resolution strategies.
Collaborate with healthcare providers, insurance companies, and patients to gather additional information needed for authorization approvals or appeals.
Use EMR and EHR systems to document actions and maintain detailed records of authorization statuses and denial resolutions.
Apply knowledge of medical coding standards including CPT, ICD-9, ICD-10, and DRG to support accurate billing processes.
Monitor outstanding authorizations and follow up regularly to prevent delays in patient care or revenue collection.
Stay current on insurance policies, healthcare regulations, and coding updates to support compliance and reimbursement outcomes.