If you’re the type who can read an insurance plan like it owes you money, this role is all about protecting revenue and patient access by getting benefits verified, authorizations secured, and denials handled fast, clean, and documented.
About Nira Medical
Nira Medical supports physician-led, patient-centered independent practices with a focus on advancing neurological care. The Infusion & Revenue Cycle Management team helps make sure patients can actually receive services without coverage surprises or avoidable delays.
Schedule
- Full-time
- Remote
- Department: Infusion & Revenue Cycle Management
What You’ll Do
- Verify and document insurance eligibility, benefits, and coverage for office visits and infusion services
- Obtain pre-authorizations and pre-certifications for office visits and infusion services
- Support denial mitigation, including peer-to-peer coordination and appeals
- Maintain strong working knowledge of payer-specific infusion drug authorization requirements and state/federal coverage guidelines
- Calculate patient financial responsibility and communicate it clearly
- Support financial assistance efforts, including identifying patient assistance programs and enrolling patients in manufacturer copay assistance
What You Need
- High school diploma or equivalent
- 2–3 years of medical insurance verification and prior authorization experience (infusion experience preferred)
- Strong knowledge of insurance terminology, plan types, and approval structures
- Experience with J-codes, CPT, and ICD-10 coding
- Ability to review clinical documentation and apply medical terminology appropriately
- Strong organization, attention to detail, and ability to multitask in a fast-paced environment
- Critical thinking and decisive judgment
- Athena experience is a plus, not required
Benefits
Not listed in the posting.
Quick gut-check: they call it “Lead,” but the description doesn’t spell out direct reports, coaching, auditing, or ownership of KPIs. So in your resume, you’ll want to prove “lead” through outcomes: faster auth turnaround, reduced denials, appeal win rate, volume handled, payer mix, infusion meds you’ve worked with, and any SOPs or training you’ve built.
Happy Hunting,
~Two Chicks…