Senior Billing Representative

Responsibilities: Confirm insurance coverage, eligibility, and benefit details for infusion-related services before treatment is scheduled or provided. Prepare and submit prior authorization requests with complete clinical and billing documentation to support timely payer review. Examine medical records and physician documentation to determine whether submitted information meets payer requirements for infusion services. Develop accurate patient cost estimates based on verified benefits, coverage limitations, and expected out-of-pocket responsibility. Communicate with patients to explain authorization status, insurance details, and anticipated financial responsibility in a clear and thorough manner. Coordinate with internal billing and clinical teams to resolve missing information, follow up on pending approvals, and prevent delays in service. Maintain accurate records of benefit verification, authorization activity, and patient communication while following HIPAA and PHI standards. Review payer responses and update account information to ensure billing workflows reflect the latest authorization and coverage outcomes.