Top 11 Prior authorization specialist Jobs in Knoxville, Tn

Medical Insurance Verification Specialist
Boulevard ENT Surgery Center —Knoxville, TN
- $18 - $20 an hour
- Full-time
- Background check
- Medical office experience
- HIPAA
- Disability insurance
- Health insurance
Quick Apply
10h
Chemotherapy Authorization Specialist
Tennessee Cancer Specialists —Knoxville, TN
- Microsoft Excel
- Microsoft Outlook
- Customer service
Patient Access Specialist, Emergency Department, Part-Time, Nights
Prisma Health —Maryville, TN
- Part-time
- Customer service
- Word processing
- Computer literacy
14d
Authorization & Verification Specialist - Acute Team
ContinuumRx —Knoxville, TN
- Full-time
- Microsoft Word
- Microsoft Excel
- HIPAA
Quick Apply
Medication Authorization Coordinator
SOUTHEASTERN RETINA ASSOCIATES PC —Knoxville, TN
- Weekends as needed
- Surgery
- HIPAA
- Mid-level
Quick Apply
Medical Insurance Verification /Reception
Allergy Specialists of Knoxville —Knoxville, TN
- $16 - $18 an hour
- Part-time
- Background check
- HIPAA
- Administrative experience
- Health insurance
- 401(k)
Quick Apply
14d
Medical Administrative Specialist 1-Hearing & Speech Center
University of Tennessee Health Science Center —Knoxville, TN
- $18.54 - $20.00 an hour
- Full-time
- Microsoft Word
- Writing skills
- Mid-level
11d
Surgical Poster
United Urology Group —Knoxville, TN
- Full-time
- Background check
- Surgery
- Ability to walk for extended periods
- Dental insurance
- Tuition reimbursement
Quick Apply
Medical Administrative Specialist 1-Hearing & Speech Center
University of Tennessee - Knoxville —Knoxville, TN
- $18.54 - $20.00 an hour
- Full-time
- Microsoft Word
- Writing skills
- Mid-level
11d
Medical Billing Specialist
ABA Interventions, LLC —Knoxville, TN
- $17 - $21 an hour
- Full-time
- Writing skills
- Medical office experience
- HIPAA
- Health insurance
- Dental insurance
Quick Apply

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Chemotherapy Authorization Specialist
Tennessee Cancer Specialists —Knoxville, TN
Associates degree in Healthcare * LPN state license and registration preferred. Lastly, we feel that you will be most successful with at least one year of…

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Prior Authorization Specialist
WSD —Westerville, OH
Must have prior experience with insurances and prior authorizations. Collaborate with clinical staff to ensure timely approvals for patient treatments.
$18 - $25 an hour
Quick Apply
12h
Insurance Verification and Prior Auth Specialist
Ohio Gastroenterology Group —Columbus, OH
Responds to patient calls about how out of network insurance is handled and provide patient with letter explaining this if necessary.
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Medical Insurance Verification Specialist

Boulevard ENT Surgery Center
Knoxville, TN

Quick Apply

Job Details

Full-time
$18 - $20 an hour
10 hours ago

Benefits

Disability insurance
Health insurance
Dental insurance
401(k)
Paid time off
Vision insurance
Life insurance

Qualifications

Medical documentation
Overseeing health insurance pre-certification
Medical office experience
High school diploma or GED
Medical administrative support
Organizational skills

Full Job Description

Insurance Verification Specialist

Department: Business Office

Reports To: Practice Administrators and/or ASD Management VP of Business Operations

Hours: 8:30am to 5:00pm

Position Summary

The Insurance Verification Specialist is responsible for verifying patient insurance benefits, obtaining required prior authorizations, calculating patient financial responsibility, and ensuring all insurance information is accurate prior to the date of service. This position works closely with physician offices, patients, and insurance carriers to facilitate timely surgical scheduling and reimbursement while providing excellent customer service.

Essential Duties and Responsibilities Insurance Verification

Verify patient eligibility and insurance benefits prior to scheduled procedures. Confirm active coverage, deductibles, co-insurance, co-payments, out-of-pocket maximums, and benefit limitations.

Determine whether the surgery center and physician are in-network with the patient's insurance plan.

Document all verification information accurately in the electronic medical record (EMR) and/or practice management system.

Identify any coverage issues and communicate findings to appropriate staff.

Prior Authorizations

Obtain prior authorizations, referrals, and pre-certifications as required by insurance carriers.

Track authorization status to ensure approvals are received before the scheduled procedure.

Communicate authorization requirements or delays to physician offices, schedulers, and clinical staff.

Maintain accurate authorization records and documentation.

Patient Financial Counseling

Calculate estimated patient financial responsibility based on verified insurance benefits.

Contact patients to discuss estimated out-of-pocket costs.

Explain deductibles, co-insurance, co-payments, and payment options in a professional and courteous manner.

Contact patients prior to their procedure to review and explain their estimated financial responsibility, including deductibles, co-insurance, co-payments, and any non-covered services.

Document patient communications regarding financial responsibility.

Cash Handling Responsibilities

Count and reconcile the petty cash fund at the end of each business day in accordance with surgery center policies and procedures.

Communication & Coordination

Serve as a liaison between physician offices, insurance companies, and surgery center staff.

Respond to insurance inquiries promptly and professionally.

Notify appropriate personnel of insurance changes or authorization issues that may impact scheduled procedures.

Assist with resolving insurance discrepancies before the date of service.

Documentation & Compliance

Maintain accurate and complete insurance verification records.

Ensure all documentation meets payer and surgery center requirements.

Maintain strict compliance with HIPAA and patient confidentiality regulations. Follow all payer guidelines and surgery center policies.

Administrative Support

Maintain organized electronic records.

Assist with special projects as assigned.

Participate in process improvement initiatives to enhance reimbursement and reduce denials.

Perform other duties as assigned

Cover Front Desk as needed

Qualifications Education

High school diploma or GED required.

Associate degree or healthcare-related education preferred.

Experience

Minimum of 2 years of medical insurance verification or medical office experience preferred. Ambulatory Surgery Center, hospital outpatient, or physician practice experience preferred.

Experience with insurance verification, prior authorizations, and benefit interpretation required.

Experience using electronic medical records and practice management software preferred.

Knowledge, Skills, and Abilities

Strong knowledge of commercial insurance, Medicare, Medicaid, and managed care plans.

Understanding of prior authorization and pre-certification requirements.

Excellent customer service and communication skills.

Strong attention to detail and organizational skills.

Ability to manage multiple priorities and meet deadlines.

Proficiency with Microsoft Office and electronic medical record systems.

Ability to work independently and collaboratively with physicians, staff, and insurance representatives.

Professional demeanor and excellent telephone etiquette.

Physical Requirements

Ability to sit for extended periods.

Frequent use of computers, telephones, and office equipment

Ability to communicate effectively with patients, physicians, insurance representatives, and staff.

Work Environment

Fast-paced ambulatory surgery center business office.

Frequent telephone and computer work.

Daily interaction with patients, physician offices, insurance companies, and surgery center staff.

Performance Expectations

Complete insurance verification within established timeframes before the date of service.

Obtain required authorizations before scheduled procedures.

Maintain accurate documentation and minimize insurance-related delays.

Demonstrate professionalism, confidentiality, and excellent customer service. Follow all HIPAA regulations and surgery center policies.

Pay: $18.00 - $20.00 per hour

Benefits:

401(k)
Dental insurance
Disability insurance
Health insurance
Life insurance
Paid time off
Vision insurance

Work Location: In person

Quick Apply

Refine Your Search

prior authorization specialist jobs in knoxville, tn

Medical Insurance Verification Specialist

Chemotherapy Authorization Specialist

Patient Access Specialist, Emergency Department, Part-Time, Nights

Authorization & Verification Specialist - Acute Team

Medication Authorization Coordinator

Medical Insurance Verification /Reception

Medical Administrative Specialist 1-Hearing & Speech Center

Surgical Poster

Medical Administrative Specialist 1-Hearing & Speech Center

Medical Billing Specialist

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