Authorization And Appeals Specialist

BioTAB Healthcare

St. Louis, MO, United States
On-site
Hipaa compliance adherence
Insurance verification and benefits analysis
Prior authorization processing
BioTAB Healthcare is seeking an Authorization and Appeals Specialist to support patients with lymphatic, wound, and circulatory disorders. The role involves processing clinical paperwork, verifying insurance coverage, and ensuring patient orders are approved and expedited through effective communication and documentation

Job Summary

  • This role is dedicated to putting the Patient First in every interaction by processing clinical paperwork and obtaining product approvals for patients with lymphatic, wound, and circulatory disorders.
  • The position requires daily interface with patients, sales teams, clinicians, and internal systems to ensure accurate documentation, shipping, and cost management for pneumatic compression devices.
  • Employees must strictly adhere to CMS regulations, Medicare fraud prevention guidelines, and maintain high-quality standards in all patient intake and case processing activities.

Matching Summary

Match Score: 85

BioTAB Healthcare is seeking an Authorization and Appeals Specialist to support patients with lymphatic, wound, and circulatory disorders. The role involves processing clinical paperwork, verifying insurance coverage, and ensuring patient orders are approved and expedited through effective communication and documentation.

Skills & Requirements

Must-have

  • HIPAA compliance adherence
  • Insurance verification and benefits analysis
  • Prior authorization processing
  • SalesForce or Epic software proficiency
  • High volume call center communication

Nice-to-have

  • Experience in DME care navigation
  • Ability to manage emotional patient situations
  • Strong organizational and time management skills
  • Collaborative team player mindset
  • Detail-oriented process execution

Key Requirements

  • High School diploma required; Associate's/Bachelor's preferred
  • 1+ years experience in healthcare operations or customer service
  • Must pass extensive background check
  • Ability to lift 40 pounds from floor to waist level

Work Rights

Not specified

Tailored Resume

Cover Letter