Medical Authorization Specialist

About the role

Enovis is seeking a Medical Authorization Specialist to join its Revenue Cycle Management team in Dallas. In this role you will ensure timely and compliant insurance authorizations, verify patient benefits, and support the invoicing process for medical products.

Key responsibilities

• Answer inbound and outbound calls, research insurance information, and resolve account issues.
• Verify insurance eligibility and follow coordination of benefits guidelines.
• Determine revenue amounts based on allowable benefits, payer guidelines, copayments, and contract pricing.
• Obtain required documentation from the Sales team before invoicing.
• Resolve submission issues by securing appropriate medical records or validating coding.
• Communicate medical necessity to insurers, negotiate coverage and pricing, and challenge decisions when needed.
• Report payer trends to Management and Payor Development.
• Maintain up‑to‑date knowledge of Enovis products, competitor offerings, and relevant clinical publications.
• Adhere to the Enovis Compliance & Ethics Program and related codes of conduct.

Required profile

• Strong attention to detail and ability to work collaboratively with internal and external teams.
• Experience handling insurance verification, benefit coordination, and medical authorization processes.
• Ability to interpret payer guidelines, coding requirements, and contract pricing.
• Effective communication skills for interacting with insurers, sales staff, and management.
• Commitment to staying current on product knowledge and industry regulations.

Required skills