Healthcare Authorization Specialist

About the position

The Healthcare Authorization Specialist is responsible for verifying insurance benefits, calculating patient responsibility estimates, and securing timely authorizations for various service types. This role requires effective communication with patients and families, as well as internal and external stakeholders, to ensure a smooth authorization process. The position is a full-time contract role that allows for remote work, specifically within the Pacific Standard Time zone.

Responsibilities
• Verify insurance benefits for patients.
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• Calculate and communicate patient responsibility estimates to patients and/or families.
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• Secure timely authorizations for all assigned service types.
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• Serve as a specialist for internal and external customer inquiries.
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• Support various communication needs as required.
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• Perform other duties as assigned.

Requirements
• High school diploma or equivalent education/experience.
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• At least 1 year of prior authorization experience with knowledge of insurance verification.
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• At least 1 year of processing and obtaining prior authorization requests for services rendered.
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• Knowledge of both HMO and PPO plans for prior authorization.
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• Experience with EMR systems such as EPIC.

Nice-to-haves

Benefits
• Dental insurance
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• Health insurance
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• Life insurance
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• Vision insurance