Ohio Licensed Medical Case Manager

Job Summary

A company is looking for a Claims & Verification Specialist.

Key Responsibilities

• Handle prior authorizations and insurance verification
• Communicate with patients, providers, and insurance payers via phone and email
• Process claims, denials, appeals, and manage billing and coding

Required Qualifications

• Minimum of 1-year recent experience with medical insurance, specifically prior authorization
• Experience with Medicare/Medicaid program administration
• Knowledge of insurance verification and claim adjudication or medical billing
• Familiarity with ICD-10, HCPCS, or CPT is a significant plus
• High School Diploma or equivalent required