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.

How Jobgether works: We use an AI-powered matching process to ensure your application is reviewed quickly, objectively, and fairly against the role's core requirements. Our system identifies the top-fitting candidates, and this shortlist is then shared directly with the hiring company. The final decision and next steps (interviews, assessments) are managed by their internal team. We appreciate your interest and wish you the best!  Why Apply Through Jobgether?    Data Privacy Notice: By submitting your application, you acknowledge that Jobgether will process your personal data to evaluate your candidacy and share relevant information with the hiring employer. This processing is based on legitimate interest and pre-contractual measures under applicable data protection laws (including GDPR). You may exercise your rights (access, rectification, erasure, objection) at any time.     #LI-CL1