Authorization & Eligibility Medical Billing Specialist

Snapscale is looking for an expert Authorization and Eligibility Medical Billing Specialist to perform the following functions:

• Verify insurance eligibility, benefits, exclusions, deductibles, co-pays, and co-insurance for occupational and speech therapy patients.
• Contact insurance providers to clarify discrepancies or misquoted benefits.
• Enter benefit details into forms and calculate patient responsibility (worst- and best-case coverage scenarios).
• Complete good-faith estimates.
• Check, submit, and track therapy authorization requirements.
• Ensure all services have valid authorizations to prevent denials.
• Upload and process data from E-Bridge Software; maintain accurate and updated EMR records.
• Review medical records to confirm authorization and eligibility accuracy.
• Use medical terminology and coding knowledge for eligibility and authorizations.
• Re-verify insurance coverage based on denial codes.
• Protect patient confidentiality and comply with HIPAA regulations.
• Work with providers and staff to resolve authorization and billing issues.
• Perform follow-up tasks related to billing as directed by the Senior Medical Billing & RCM Manager.

• 5+ years of experience handling insurance authorizations, eligibility, and benefits verification for OT, PT, and SLP clinics (pediatrics preferred)
• Proficient in insurance portals, calling insurers, and EMR data entry
• Ideal candidate has experience with Fusion Web Clinic EMR (Therapy Brands)
• Experienced in billing for OT, PT, and SLP services
• Background in private practice settings preferred
• Strong medical terminology, anatomy, and insurance billing knowledge
• Detail-oriented, hardworking, and diligent
• Tech-savvy and quick to learn new EMR systems
• Accurate in coding and billing with strong understanding of reimbursement processes
• Clear communicator; able to work effectively with providers, insurers, and patients
• Highly reliable and responsive