Medical Billing Bilingüe

Insurance Authorization & Billing Specialist

100% On site position.

Schedule: Kenya Time Conversion (EAT): 3:00 PM – 12:00 Midnight (Monday to Friday)

Job Description

The Insurance Authorization & Billing Specialist is responsible for processing and managing insurance authorizations for healthcare services, ensuring accuracy and full compliance with payer requirements. The role involves handling Medicare billing processes, including claims submission, corrections, follow-ups, and denial management. The specialist verifies patient insurance eligibility and benefits for both Medicare and commercial insurers, communicates directly with insurance providers to obtain approvals and resolve issues, and ensures timely reimbursements. The position requires maintaining accurate billing documentation, collaborating with internal teams such as scheduling, clinical, and operations, proactively managing authorization renewals, and adhering strictly to HIPAA and compliance standards.

Key Responsibilities

· Process and manage insurance authorizations in accordance with payer guidelines.

· Handle Medicare billing, including claims submission, corrections, follow-ups, and denials management.

· Verify patient insurance eligibility and benefits with Medicare and commercial insurers.

· Communicate with insurance providers to obtain approvals and resolve authorization or billing issues.

· Maintain accurate and up-to-date documentation within billing systems.

· Collaborate with scheduling, clinical, and operations teams to ensure services are authorized and billed correctly.

· Monitor authorization expiration dates and proactively manage renewals.

· Ensure full compliance with HIPAA and healthcare regulations.

Skills & Qualifications

· Minimum 2+ years of experience in healthcare billing and insurance authorizations.

· English Level B2+,C1

· Strong experience with Medicare billing and authorizations (required).

· Hands-on experience with Medicare and commercial insurance claims.

· Solid understanding of payer requirements and healthcare compliance standards.

· High attention to detail and strong organizational skills.

· Ability to manage multiple cases and priorities in a fast-paced environment.

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