Top 7 Prior authorization specialist Jobs in Saginaw, Mi

Medical Insurance Verification Specialist
MACKINAW SURGERY CENTER —Saginaw, MI
- From $18 an hour
- Full-time
- Medical office experience
- HIPAA
- Mid-level
- Disability insurance
- Health insurance
Quick Apply
Medical Records Technician (Release of Information)
US Veterans Health Administration —Saginaw, MI
- $38,950 - $63,151 a year
- Online Application
- Background check
- High school
- Pass drug screening
- Health insurance
8d
SURGERY SCHEDULER - ORTHOPEDICS GRATIOT
Covenant HealthCare —Saginaw, MI
- Full-time
- Surgery
- Medical office experience
- HIPAA
- Health insurance
- Dental insurance
Medical Receptionist
Total Family Healthcare PC —Bay City, MI
- $16.50 - $17.50 an hour
- Full-time
- HIPAA
- High school diploma or GED
- Organizational skills
- Health insurance
- 401(k)
Quick Apply
Patient Services Assistant
MyMichigan Health —Midland, MI
- 8 hour shift
- Current TB test
- Ability to walk for extended periods
- BLS Certification
7d

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Prior Authorization Specialist
Equitas Health, Inc. —Columbus, OH
Reliable transportation, driver’s license and proof of auto insurance required. Essential job functions include, but are not limited to, driving or having…
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Medical Insurance Verification Specialist

MACKINAW SURGERY CENTER
Saginaw, MI

Quick Apply

Job Details

Full-time
From $18 an hour

Benefits

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

Qualifications

Interpersonal skills
HIPAA
High school diploma or GED
Attention to detail
Organizational skills

Full Job Description

Insurance Verification Specialist

Job Title: Insurance Verification Specialist

Department: Business Office

Reports To: Business Office Manager/Administrator

Supervises: None

Position Summary

The Insurance Verification Specialist is responsible for verifying patient insurance benefits for outpatient surgical procedures to ensure accurate reimbursement and financial transparency. This position coordinates the verification process in accordance with facility policies and procedures to meet the needs of both patients and physicians. The specialist communicates patient financial responsibility, including deductibles, co-payments, and co-insurance amounts, while maintaining excellent customer service and ensuring all required authorizations are obtained prior to surgery.

Essential Duties and Responsibilities

Verify medical insurance eligibility and benefits for all scheduled outpatient surgical procedures.
Accurately determine and communicate patient financial responsibility, including:
Co-payments
Deductibles
Co-insurance
Out-of-pocket estimates
Coordinate the verification of scheduled procedures in accordance with facility policies and procedures.
Obtain and document insurance benefit information in the appropriate electronic systems.
Work closely with physician offices, patients, insurance companies, and facility staff to ensure all insurance requirements are met before the date of service.
Verify that prior authorizations and pre-certifications as required by insurance carriers.
May perform responsibilities related to pre-certifying admissions and outpatient procedures.
Review insurance coverage to identify any limitations, exclusions, or authorization requirements.
Notify appropriate staff of any insurance issues that could delay or impact patient care or reimbursement.
Maintain accurate documentation of all verification and authorization activities.
Ensure compliance with HIPAA, payer regulations, and facility confidentiality policies.
Assist patients with questions regarding insurance benefits and estimated financial responsibility.
Stay current on payer policies, insurance requirements, and regulatory changes.
Perform other duties as assigned by the Business Office Manager.

Qualifications

Education

High school diploma or equivalent required.

Experience

Minimum of one to two years of experience in medical insurance verification, patient registration, medical billing, or a healthcare business office preferred.
Experience in an ambulatory surgery center or outpatient healthcare setting preferred.

Knowledge, Skills, and Abilities

Knowledge of commercial insurance, Medicare, Medicaid, and managed care plans.
Understanding of deductibles, co-payments, co-insurance, and benefit verification processes.
Knowledge of prior authorization and pre-certification requirements.
Strong attention to detail and organizational skills.
Excellent verbal and written communication skills.
Ability to maintain confidentiality and handle sensitive information.
Strong customer service and problem-solving skills.
Ability to prioritize multiple tasks in a fast-paced environment.
Proficiency with electronic medical records (EMR), practice management systems, and Microsoft Office applications.

Physical Requirements

Prolonged periods of sitting and computer work.
Ability to communicate effectively by telephone and in person.
Ability to occasionally lift up to 20 pounds.

Working Conditions

Office environment within an ambulatory surgery center.
Frequent interaction with patients, physicians, insurance representatives, and facility staff.

Performance Expectations

The Insurance Verification Specialist is expected to:

Complete insurance verification accurately and in a timely manner.
Ensure required authorizations are obtained prior to scheduled procedures.
Provide accurate patient financial estimates.
Maintain complete and accurate documentation.
Demonstrate professionalism, confidentiality, and excellent customer service at all times.

This job description is intended to describe the general nature and level of work performed in this position. It is not intended to provide an exhaustive list of all duties, responsibilities, or qualifications required for the position. Nor is it intended to limit the right of any manager to assign or direct the work of employees under his or her supervision. Duties and responsibilities may be modified at any time to meet the changing needs of the facility.

Pay: From $18.00 per hour

Benefits:

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

Work Location: In person

Quick Apply

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prior authorization specialist jobs in saginaw, mi

Medical Insurance Verification Specialist

Medical Records Technician (Release of Information)

SURGERY SCHEDULER - ORTHOPEDICS GRATIOT

Medical Receptionist

Patient Services Assistant

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