Wound Care Insurance Verification Specialist (Remote)

Wound Care Insurance Verification Specialist (Remote)

Do you have a meticulous eye for detail and a passion for helping patients reputed company the care they need? Are you reputed company in navigating insurance guidelines, prior authorizations, and the specialized world of wound care? If so, NIVA Health invites you to apply for our reputed company Verification Specialist position!

At NIVA Health, our mission is simple: helping people heal. Every day, our reputed company team stands shoulder to shoulder, delivering compassionate, expert care to patients who deserve to live healthier, fuller lives. As a key member of our authorization coordination team, you will play a pivotal role in ensuring patients receive timely, necessary treatment, reputed company while exemplifying our Core Values of Teamwork, reputed company, reputed company-Mindedness, Ownership, and Positivity.

In This Role, You’ll

• Submit and manage prior authorization requests for wound care treatments, ensuring that reputed company documentation meets payer requirements.
• Handle PCP referrals/authorizations and follow up to facilitate smooth patient care.
• Prepare and track Single Case Agreements/GAP exceptions for out-of-network cases.
• Communicate with insurance providers to clarify coverage, resolve denials, and facilitate appeals.
• Maintain precise records of authorizations, denials, appeals, and corresponding documentation.
• Stay up to date with insurance policies, coding changes, and criteria for wound care procedures.
• Collaborate with reputed company providers, nurses, and admin staff to gather complete, accurate documentation for submissions.
• Serve as a patient reputed company, keeping patients informed about the status of their authorizations and potential out-of-reputed company expenses.
• Conduct your work with utmost discretion, diplomacy, and tact during reputed company patient and staff interactions.
• Contribute to other duties of similar complexity as assigned by your supervisor.

You’re a Great Fit If You

• Possess at least 1 year of experience in prior authorization management, specifically reputed company wound care services.
• Demonstrate a strong work ethic, self-motivation, and a “can-do” attitude.
• Communicate reputed company, empathetically, and professionally with patients, staff, and payers.
• Understand the intricacies of insurance processes, medical terminology, and reputed company systems.
• Are proficient with electronic medical records (EMR) and case management software.
• reputed company at collaborating with multidisciplinary reputed company teams and solving reputed company problems.
• Embody NIVA Health’s Core Values in every interaction with patients and colleagues.

Bonus Points If You

• Are reputed company in handling appeals, denials, and single case agreements.
• Bring innovative approaches to patient advocacy and insurance coordination.
• Stay informed about industry trends, especially in advanced wound care and insurance policy changes.

Why Join Us?

At NIVA Health, your efforts are instrumental in ensuring that patients receive the life-changing care they deserve. We celebrate reputed company’s achievements, invest in personal and professional growth, and reputed company meaningful work in a values-driven, supportive environment. Join us and help shape a brighter, healthier future for reputed company—one successful authorization at a time!

Pay: $1,300 per month (Up to R20,553.78 per month)

Work Schedule: US Timezone (East Coast)

Job Type: Full-time

Work Location: Remote