Billing & Authorization Specialist

Accountabilities

• Review billing codes, insurance authorizations, and supporting documentation for accuracy, completeness, and compliance.
• Ensure all required insurance authorizations are secured before services are billed.
• Monitor authorization periods, proactively identifying upcoming expirations and managing extensions or renewals.
• Enter and maintain accurate authorization and billing information within EMR and medical billing systems.
• Verify that services are billed only when valid and appropriate authorizations are in place.
• Follow up with therapists, clinicians, and providers when documentation, treatment information, or authorization details are missing or incomplete.
• Communicate directly with insurance companies regarding authorization status, extensions, denials, payer requirements, and billing-related questions.
• Investigate and resolve billing discrepancies and authorization issues efficiently and accurately.
• Maintain organized records of authorizations, billing information, correspondence, and related documentation.
• Ensure billing and authorization activities follow applicable payer requirements and internal procedures.
• Identify potential issues proactively before they affect service delivery or reimbursement.
• Collaborate with internal teams to resolve outstanding matters and maintain smooth communication across the billing and clinical processes.
• Use EMR and billing platforms effectively to support accurate and timely healthcare administration.

Requirements

• Previous professional experience in medical billing and insurance authorizations.
• Strong understanding of CPT codes, medical billing processes, insurance authorizations, and payer requirements.
• Demonstrated experience obtaining, maintaining, updating, extending, and resolving denied or missing authorizations.
• Experience working with EMR and/or medical billing software.
• Strong attention to detail, accuracy, and consistency when handling sensitive billing and authorization information.
• Excellent organizational and administrative skills, with the ability to manage multiple authorizations, deadlines, and follow-ups simultaneously.
• Strong communication skills and confidence interacting professionally with therapists, clinicians, healthcare providers, and insurance companies.
• Ability to investigate discrepancies, identify root causes, and resolve issues independently.
• Proactive approach to identifying potential authorization and billing problems before they affect operations or reimbursement.
• Ability to work independently and remain organized in a fully remote environment.
• Experience in pediatric healthcare, pediatric therapy, Early Intervention, behavioral health, or a comparable healthcare setting is highly advantageous.
• Strong ability to prioritize tasks and meet deadlines while maintaining a high standard of accuracy.
• Availability to work US business hours, approximately 9:00 AM–5:00 PM EST.

Benefits

• Fully remote, full-time position based in South Africa.
• Work aligned with US business hours (9:00 AM–5:00 PM EST).
• Compensation paid in South African Rand (ZAR).
• Opportunity to work within a healthcare environment where accurate billing and authorization directly support service delivery and reimbursement.
• Collaborative role involving regular interaction with clinical professionals, healthcare providers, and insurance companies.
• Opportunity to develop and apply expertise in medical billing, insurance authorization, EMR systems, and payer processes.
• High level of responsibility and ownership over billing and authorization workflows.