Accounts Receivable Insurance Authorization Specialist

Accounts Receivable Insurance Authorization Specialist

Basic Summary:

The Accounts Receivable Insurance Authorization Specialist (ARIA Specialist) combines the core duties of accounts receivable management with the specific task of coordinating insurance authorizations for patient services. This role ensure that billing and collections processes are supported by proper insurance pre-authorization, eligibility verification and documentation submission.

Primary Responsibilities:

· Resolve billing disputes and discrepancies with customers or third parties.

· Maintain accurate records of all payments received from patients, insurance companies, Medicare, or other payors.

· Follow up on unpaid, denied, or rejected claims and document all actions.

· Coordinate and process prior authorizations for hospice services, ensuring all required documentation is submitted to insurance carriers or Medicare.

· Verify patient insurance eligibility and benefits, confirm coverage for ordered services.

· Troubleshoot authorization-related issues in the practice management or billing system.

· Maintain contact management for tracking authorization status and required documentation.

· Work with insurance plans to pre-authorize and re-authorize patient services.

· Review Explanation of Benefits (EOB) and research denials, rejections, or excessive reductions.

· Prepare and submit accurate claims to third-party insurance carriers, either electronically or via hard copy.

· Ensure compliance with healthcare plan requirements and internal billing policies.