Top 77 Prior authorization specialist Jobs in North Carolina

Insurance Verification Specialist - 3147/Remote - Full Time
Wilmington Health PLLC —Wilmington, NC
- Full-time
- Remote
- HIPAA
- High school diploma or GED
- Organizational skills
Authorization Specialist
EMERGEORTHO, P.A. —Wilmington, NC
- Full-time
- Mid-level
- High school diploma or GED
- Organizational skills
- Health savings account
- Paid holidays
Quick Apply
Patient Access Specialist
McKesson —Cary, NC
- $15.93 - $26.55 an hour
- Hybrid work
- Computer literacy
- HIPAA
- Office
- Prescription drug insurance
Sr. Patient Access Inbound Specialist
McKesson —Cary, NC
- $19.87 - $33.11 an hour
- Mid-level
- 3 years
- Communication skills
13d
Pre Certification Collection Specialist
OrthoCarolina —Charlotte, NC
- Full-time
- Hybrid work
- Mid-level
- Office
- Analysis skills
- Paid holidays
- Tuition reimbursement
Quick Apply
Admissions Coordinator & Authorization/UR Specialist
Joshua Tree Health —Apex, NC
- Full-time
- HIPAA
- 3 years
- Data entry
Quick Apply
Prior Authorization Specialist
Blue Ridge Health —Hendersonville, NC
- Full-time
- Spanish
- Mid-level
- High school diploma or GED
- 403(b) matching
- Paid holidays
Quick Apply
Authorization Specialist
Carolina Oncology Specialists —Hickory, NC
- Full-time
- Customer service
- Mid-level
- High school diploma or GED
Quick Apply
5d
Pre-Arrival Specialist
UNC Health —Hendersonville, NC
- Full-time
- Hybrid work
- Mid-level
- High school diploma or GED
- Medical terminology
Revenue Cycle Specialist
AuthoraCare Collective —Greensboro, NC
- Full-time
- Remote
- HIPAA
- Mid-level
- High school diploma or GED
- 403(b) matching
- Paid holidays
Quick Apply
6d
Reimbursement Specialist
McKesson —Cary, NC
- $17.99 - $29.98 an hour
- Research
- Mid-level
- Microsoft Office
12h
Patient Access - Intake Specialist - Emergency Department
UNC Health —Rocky Mount, NC
- Full-time
- High school diploma or GED
- ER
- In-person
14d
Patient Access Specialist
Rowan Diagnostic Clinic, PA —Salisbury, NC
- Extended hours
- Spanish
- OSHA
- HIPAA
Part-Time Surgical Prior Authorization & Administrative Coordinator
InStride Foot & Ankle Specialists —Supply, NC
- $22 - $26 an hour
- Part-time
- Surgery
- Medical office experience
- Perioperative Care
Quick Apply
4d
Surgery Scheduler
EMERGEORTHO, P.A. —Wilmington, NC
- Full-time
- Anatomy knowledge
- Surgery
- Computer literacy
- Health savings account
- Paid holidays
Quick Apply
Documentation Specialist
AdaptHealth, LLC —Asheville, NC
- Hybrid work
- Background check
- HIPAA
- Administrative experience
- Paid parental leave
- Health savings account
Quick Apply
Pharmacy Benefits Specialist
CAROLINA ASTHMA AND ALLERGY CENTER —Shelby, NC
- Full-time
- Customer service
- Office
- High school diploma or GED
Quick Apply
Patient Access Specialist - Wound and Infusion Center
UNC Health —Kinston, NC
- Full-time
- Hospital
- Customer service
- HIPAA
Surgery Scheduler- Duke Lake Norman Ortho Spine
Duke Health —Mooresville, NC
- Full-time
- Surgery
- Hospital
- Mid-level
5d
Automotive Customer Support Specialist
Concentrix —North Carolina
- $23 an hour
- Urgently hiring
- Hybrid work
- 18 years or older
- Computer literacy
- Writing skills
- Paid holidays
- Health insurance
11d

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Insurance Verification Specialist - 3147/Remote - Full Time

Wilmington Health PLLC -
Wilmington, NC

Apply Now

Job Details

Full-time

Qualifications

Electronic health records (EHR) management
High school diploma or GED
Health information management
Medical terminology

Full Job Description

About Wilmington Health

Since 1971, Wilmington Health has been committed to the care and health of our community in Wilmington as well as all of Southeastern North Carolina. Wilmington Health is structured as a multi-specialty medical practice with primary care providers integrated into the system. In this way, Wilmington Health is able to provide a comprehensive and coordinated approach to the care of all our patients. Wilmington Health is committed to using collaborative, evidence-based medicine in providing the highest quality of care to the patients we serve.

Job Summary:

The Insurance Verification Specialist plays a critical role in ensuring that patients' insurance coverage is verified accurately and efficiently before services are provided. This position is responsible for verifying active insurance coverage, including service-specific benefits, documenting copays and deductibles, and ensuring the appropriate authorizations are in place for specified services. The Specialist will also stay current on changes in insurance regulations and maintain detailed, accurate records within the electronic health record (EHR) system.

Essential Duties/Responsibilities:

Insurance Entry and Verification

Enter insurance information into the EHR system.
Verify active insurance coverage through payer websites.
Document copay and deductible information for each patient.
Add insurance card images to patient files when available through payer websites.

Insurance Updates

Ensure that insurance is still active prior to the patient’s appointment or procedure.
Reach out to patients to resolve inactive insurance status and obtain updated information.
Verify and update copay and deductible details as necessary.
Retrieve and attach snippets of insurance cards from payer websites to ensure the most up-to-date records.

Authorization Management

Verify and document that required authorizations are in place for specific services, including Tricare, VA, special testing (e.g., MRIs, CT scans, ultrasounds), and injections.
Ensure all necessary pre-authorizations are obtained for high-risk or special procedures.

Compliance and Continuous Learning

Stay up to date with changes in insurance regulations, payer policies, and healthcare laws.
Ensure compliance with HIPAA regulations and internal policies to protect patient information.

Other Duties:

Other duties as assigned.

Qualifications:

Exceptional attention to detail and a high degree of accuracy.
Excellent verbal and written communication skills.
Strong interpersonal skills, with the ability to work effectively in a fast-paced, team-oriented environment.
Demonstrated ability to solve problems independently and manage difficult situations with patience and professionalism.
Familiarity with HIPAA regulations and ensuring confidentiality and security of patient data.
Strong organizational skills.
Adaptable to frequent changes in insurance policies.
Ability to handle multiple tasks efficiently.

Required:

Education: High school diploma or equivalent.
Experience: Prior experience in healthcare insurance verification or a related field.

Knowledge:

Strong understanding of medical terminology, various insurance plans, and billing procedures.
Proficiency in using EHR and billing software.

Preferred:

ADA Physical Demands:

Rarely (Less than .5 hrs/day) Occasionally (0.6 – 2.5 hrs/day) Frequently (2.6 – 5.5 hrs/day) Continuously (5.6 – 8.0 hrs/day)

Physical Demand

Required?

Frequency

Standing

Occasionally

Sitting

Continuously

Walking

Rarely

Kneeling/Crouching

Lifting

Apply Now

Refine Your Search

prior authorization specialist jobs in north carolina

Insurance Verification Specialist - 3147/Remote - Full Time

Authorization Specialist

Patient Access Specialist

Sr. Patient Access Inbound Specialist

Pre Certification Collection Specialist

Admissions Coordinator & Authorization/UR Specialist

Prior Authorization Specialist

Authorization Specialist

Pre-Arrival Specialist

Revenue Cycle Specialist

Reimbursement Specialist

Patient Access - Intake Specialist - Emergency Department

Patient Access Specialist

Part-Time Surgical Prior Authorization & Administrative Coordinator

Surgery Scheduler

Documentation Specialist

Pharmacy Benefits Specialist

Patient Access Specialist - Wound and Infusion Center

Surgery Scheduler- Duke Lake Norman Ortho Spine

Automotive Customer Support Specialist

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