Insurance Authorization Specialist
Job Summary
To support the efficient delivery of specialized healthcare services, the full-time Insurance Authorization Specialist will secure financial clearance and complete pre-authorizations for complex, high-dollar inpatient and outpatient surgical procedures, hematology/oncology treatments, and infusion services while working remotely.
Key responsibilities:
- Secure pre-authorizations from insurance companies for a broad range of complex healthcare services
- Review medical records and supporting documentation to ensure accurate submission for ordered services
- Communicate effectively with healthcare providers, insurance carriers, and patients to facilitate 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 reviewing medical policies and interpreting CPT and HCPCS codes
- Completion of a health vocational program (e.g., Medical Assistant, Medical Billing & Insurance) preferred
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