Insurance Authorization Specialist

Job Summary

To support patient financial clearance, the full-time Insurance Authorization Specialist will obtain authorizations for elective procedures and services, verify insurance requirements, and ensure accurate coding while working remotely.

Key responsibilities

• Identifies patients requiring pre-certification or pre-authorization and contacts insurance companies to determine eligibility and benefits
• Utilizes the EPIC system to obtain authorizations for referrals, tests, and surgeries, ensuring timely follow-up on requests
• Reviews medical documentation to support authorization processes and assists with denial management and appeals as needed

Required qualifications

• High school diploma or equivalent with 2 years of experience in a medical environment, or an Associate's degree with 1 year of experience
• Knowledge of medical terminology, ICD-10, and CPT coding
• Understanding of authorization processes and insurance guidelines
• Proficiency in Microsoft Office applications
• Excellent time management and organizational skills to handle a high volume of work efficiently