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 needing pre-certification or pre-authorization and contacts insurance providers to determine eligibility and benefits
• Utilizes the EPIC system to manage authorization requests and follows up on submissions to ensure timely processing
• Reviews medical documentation for accuracy and assists with denial management and retro-authorizations 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 required
• Knowledge of medical terminology, ICD-10, and CPT coding
• Understanding of authorization processes and insurance guidelines
• Proficiency in Microsoft Office applications
• Ability to manage multiple tasks and meet deadlines efficiently