Insurance Authorization Specialist

Job Summary

To support efficient patient care, the full-time Insurance Authorization Specialist will obtain authorizations for elective procedures and services, ensuring financial clearance prior to service delivery 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, following up on submitted requests in a timely manner
• Ensures accurate coding of diagnoses and procedures, collaborates with internal teams, and assists with denial management and retro-authorizations

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, insurance guidelines, and third-party payors
• Proficiency in Microsoft Office applications
• Ability to manage time effectively and prioritize tasks in a high-volume work environment