Insurance Authorization Specialist

About the role

We are seeking an Insurance Authorization Specialist to join our team. The ideal candidate will play a part of the patient’s experience and assist in facilitating when the physician determines that the patient is a candidate for surgery. The Authorization Specialist works with the scheduling coordinators and insurance carriers to obtain authorization, coordinate peer-to-peer calls, generate and collect surgery estimates, plus any additional steps needed for their procedure.

What you'll do

• Manage and maintain accurate medical records in compliance with HIPAA regulations.
• Perform insurance verification to ensure coverage and eligibility for services provided.
• Collaborate with managed care organizations to facilitate patient care and streamline processes.
• Verify insurance coverage and precertification for patient appointments including copay, deductible, and co-insurance
• Determine patient fee responsibility electronically and/or by phone
• Update insurance information for existing patients
• Communicate effectively with patients, providers, and insurance companies regarding medical terminology and procedures.
• Maintain organized office operations to support the overall efficiency of the medical practice.
• Navigate insurance carrier portals
• Outbound pre-certification calls
• Detail and ability to multi-task
• Maintain the daily worklist through applicable applications
• Maintain the daily surgery denial worklist

Qualifications 

• Knowledge of HIPAA regulations and commitment to patient confidentiality.
• Experience with insurance verification processes and managed care systems.
• Familiarity with medical terminology and record management systems.
• Strong organizational skills with attention to detail in a fast-paced environment.
• Excellent communication skills, both written and verbal, to interact effectively with patients and healthcare professionals.
• Previous experience in a medical office or related field is a plus but not required.

Join us in making a difference in patient care through your expertise as a Specialist!