Job Overview
We are seeking a highly motivated and detail-oriented Medical Insurance Authorization Specialist to join our dynamic healthcare team. In this vital role, you will be responsible for managing insurance prior authorization processes, ensuring timely approvals for patient treatments and procedures. Your expertise in health insurance policies, medical coding, and electronic health records (EHR) management will help streamline patient care coordination and enhance overall operational efficiency. If you thrive in a fast-paced environment, possess excellent customer service skills, and have a passion for healthcare administration, this position offers an exciting opportunity to make a meaningful impact on patient outcomes.
Responsibilities
- Review and process insurance prior authorization requests accurately and efficiently, ensuring compliance with healthcare policies and guidelines.
- Verify patient insurance coverage, benefits, and eligibility using electronic health records (EHR) systems and other tools.
- Collaborate with healthcare providers, insurance companies, and patients to gather necessary documentation for authorization submissions.
- Maintain detailed records of authorization requests, approvals, denials, and follow-up actions in accordance with clinical confidentiality policies.
- Utilize medical terminology, CPT coding (Current Procedural Terminology), ICD-9/ICD-10 (International Classification of Diseases), and ICD coding to support accurate claim processing.
- Ensure adherence to HIPAA regulations to protect patient privacy and confidentiality at all times.
- Communicate effectively with patients regarding their insurance coverage status, financial responsibility, and assist with resolving authorization issues promptly.
- Communicate effectively with patients regarding instructions needed for their upcoming procedures.
- Committed to being a team player by performing all duties as required or assigned to provide quality patient care.
Experience
- Proven experience in medical office administration or healthcare support roles, preferably within health insurance environments.
- Strong knowledge of health insurance policies, medical billing, insurance verification, and prior authorization procedures.
- Familiarity with EMR/EHR systems and electronic health records management tools.
- Proficiency in Microsoft Office applications including Word, Excel, and Outlook for documentation and communication purposes.
- Knowledge of medical terminology, medical records management, and clinical confidentiality policies is essential.
- Experience with CPT coding, ICD coding (ICD-9/ICD-10), medical coding practices, and insurance claim processing is highly desirable.
Join our team to play a crucial role in facilitating seamless healthcare delivery through expert management of insurance authorizations! We are committed to fostering an inclusive environment where your skills contribute directly to improved patient care while supporting your professional growth in the healthcare industry.
Pay: $15.00 - $18.00 per hour
Benefits:
- 401(k)
- 401(k) matching
- Dental insurance
- Employee discount
- Health insurance
- Life insurance
- Paid time off
- Retirement plan
- Vision insurance
Work Location: In person
