Insurance Authorization Specialist

Job Summary

To support a growing healthcare team, the full-time Insurance Authorization Specialist will secure financial clearance and complete pre-authorizations for complex surgical procedures and treatments while working remotely.

Key responsibilities:

• Secure pre-authorizations from insurance companies for high-dollar healthcare services, including surgical procedures and oncology treatments
• Review medical records and documentation to ensure accurate submission for authorization requests
• Communicate with healthcare providers and insurance carriers to gather necessary information for authorization decisions

Required qualifications:

• Minimum two (2) years of experience in complex prior-authorizations or insurance billing within a healthcare setting
• Customer service experience in healthcare
• Proficiency in medical terminology, validated by examination
• Experience interpreting CPT and HCPCS codes in alignment with payer guidelines
• Completion of a health vocational program (e.g., Medical Assistant, Medical Billing & Insurance) preferred