Position Summary
The Authorization and Insurance Verification Specialist is primarily responsible for insurance eligibility verification, data entry, obtaining referrals, and securing prior authorizations for diagnostic testing and cardiac procedures. This position requires thorough knowledge of insurance policy requirements, and procedural guidelines. The ideal candidate will demonstrate strong communication skills and the ability to work effectively with patients, insurance payers, physicians, and internal staff in both written and verbal formats.
Minimum Qualifications for Employment
- High school diploma or equivalent required, with a minimum of one to three (1–3) years of experience in a healthcare setting performing eligibility verification, billing and insurance processes, referrals, authorizations, and direct coordination with insurance providers. Experience within a specialty physician practice is strongly preferred. Candidates without prior healthcare experience will not be considered.
- Strong organizational skills with the ability to effectively prioritize tasks, manage multiple responsibilities, and perform efficiently in a fast‑paced, high‑volume environment.
- Exceptional attention to detail and a demonstrated commitment to accuracy and quality.
- Proven ability to establish and maintain positive, collaborative working relationships with physicians, clinical staff, administrative teams, and management.
- Proficiency in Microsoft Office applications, including Outlook, Word, and Excel, as well as comfort using internet-based tools and systems.
- Ability to work independently with minimal supervision, while also contributing effectively as part of a team.
- Prior experience with the Epic Electronic Health Record (EHR) system is strongly preferred.
Essential Duties and Responsibilities
- Obtain prior authorizations for diagnostic testing and cardiac procedures in accordance with payer requirements.
- Maintain assigned daily appointment schedules in compliance with departmental standards.
- Verify patient registration information and correct errors within assigned work queues.
- Follow up with patients, insurance payers, providers, and internal staff to resolve outstanding issues in a timely manner.
- Obtain required referrals from primary care providers when applicable.
- Perform other duties as assigned.
Work Schedule and Location
- Full-time position, 40 hours per week, Monday through Friday
- On-site position: remote work is not available
Compensation and Benefits
This position offers a competitive salary and comprehensive benefits package.
Job Type: Full-time
Pay: $21.00 - $24.00 per hour
Benefits:
- 401(k)
- Dental insurance
- Disability insurance
- Employee assistance program
- Flexible spending account
- Health insurance
- Life insurance
- Paid time off
- Vision insurance
Ability to Commute:
- Springfield, MA 01107 (Required)
Ability to Relocate:
- Springfield, MA 01107: Relocate before starting work (Required)
Work Location: In person
