Are you experienced in insurance verification, prior authorizations, or healthcare reimbursement? Do you have strong attention to detail and enjoy coordinating with insurance companies and clinical teams? We are seeking a Pre-Authorization Insurance Specialist to support our Skilled Nursing facilities and help ensure residents receive timely access to medically necessary skilled services. In this role, you will play an important part in the admission and authorization process by working closely with hospitals, residents and families, clinical teams, and insurance providers. Your ability to stay organized, meet deadlines, and follow through on authorization requirements will help support both quality patient care and successful facility operations. What You'll Do Verify insurance eligibility, benefits, coverage, and authorization requirements for skilled nursing services. Obtain prior authorizations for Medicare Advantage, Medicaid, managed care, commercial insurance, and other payer plans. Review hospital and clinical documentation to identify information required to support skilled nursing authorization. Submit authorization requests and supporting documentation through payer portals, fax, telephone, or other approved methods. Coordinate with hospitals, referral sources, nursing, therapy, and other clinical departments to obtain required documentation. Track authorization requests from initial submission through approval, denial, or request for additional information. Monitor authorization expiration dates, approved days, visit limits, and continued-stay requirements. Follow up proactively with insurance companies to prevent delays in admissions, continued stays, or medically necessary services. Communicate authorization status and payer requirements clearly to facility leadership and clinical teams. Document authorization numbers, approved dates, payer requirements, and other pertinent information accurately. Assist with continued-stay reviews, additional days, extensions, appeals, and reconsiderations when appropriate. Identify potential authorization or coverage issues and escalate concerns promptly. Maintain accurate records while ensuring compliance with HIPAA, payer requirements, and company policies. Support the facility's efforts to provide a smooth transition from hospital to skilled nursing care. Perform other related duties as assigned. What We're Looking For The ideal candidate is organized, proactive, detail-oriented, and comfortable working in a fast-paced healthcare environment. You should be able to manage multiple authorizations and deadlines while maintaining excellent communication with insurance providers and clinical teams.

Qualifications:

High school diploma or equivalent required. Previous experience in skilled nursing, healthcare insurance, prior authorization, medical billing, reimbursement, or healthcare administration preferred. Knowledge of Medicare, Medicaid, Medicare Advantage, managed care, and commercial insurance preferred. Understanding of skilled nursing services and payer authorization requirements. Familiarity with medical terminology and clinical documentation. Strong organizational and time-management skills. Excellent verbal and written communication skills. Strong follow-up and problem-solving abilities. Proficiency with computers, electronic medical records, payer portals, and Microsoft Office. Ability to maintain confidentiality and appropriately handle protected health information. Skilled Nursing Experience Is a Plus! Candidates with experience in SNF admissions, insurance verification, case management, utilization review, medical billing, or managed care authorizations are encouraged to apply. Why Join Our Team? Your work will directly support our residents and clinical teams by helping ensure that medically necessary skilled services are authorized, approved, and delivered without unnecessary delays. If you are someone who takes ownership, stays organized, communicates well, and enjoys being an important part of the healthcare process, we want to hear from you! Compensation & Benefits Compensation will be based on experience and qualifications.

Eligible employees access to:

Health insurance Paid time off Retirement options Additional company benefits Benefits are subject to applicable eligibility requirements and company policy.

Benefits:

401(k) Dental insurance Disability insurance Health insurance Health savings account Life insurance Paid time off Retirement plan Vision insurance Wellness program

Work Location:

In person