We are seeking an experienced Insurance Authorization & Procedure Clearance Specialist to join a busy procedural medical practice. This role is responsible for ensuring patients are properly cleared for scheduled procedures by verifying insurance coverage and benefits, obtaining required prior authorizations and referrals, determining estimated patient responsibility, and resolving insurance issues before the date of service. The ideal candidate has hands-on experience working with medical insurance plans and understands that obtaining an authorization is a process that requires accurate submission, consistent follow-up, and careful documentation. Previous medical insurance verification and prior authorization experience is required. Key Responsibilities Responsibilities include managing assigned patients through the insurance clearance process, including: Verify active insurance coverage and eligibility. Review plan benefits and coverage requirements for in-office procedures. Determine deductibles, copays, coinsurance, and estimated patient responsibility. Identify prior authorization and referral requirements. Submit procedure authorization requests through payer websites, authorization portals, or directly to insurance companies. Monitor pending authorization requests and follow them through approval, denial, or additional-information requests. Obtain insurance referrals when required by the patient's plan. Review authorization approvals for accuracy, including approved procedure codes, dates of service, and authorized services. Verify anesthesia coverage and benefits when applicable. Communicate estimated procedure costs and patient responsibility to patients before scheduled services. Collect required pre-procedure payments and establish payment arrangements according to office guidelines. Contact referring providers when referrals, records, or additional information are needed. Maintain accurate authorization and procedure tracking records. Document benefit information, insurance calls, authorization status, reference numbers, and patient communications in the EMR. Identify insurance or authorization issues that could affect a scheduled procedure and promptly communicate them to the appropriate staff. Work closely with clinical, scheduling, and billing teams to help prevent authorization-related delays and denials. Required Experience Applicants must have previous healthcare experience involving medical insurance verification and prior authorizations . Experience in several of the following areas is preferred: Commercial insurance plans Medicare Prior authorization portals and payer websites Procedure benefit verification Patient cost estimates eClinicalWorks (eCW) Microsoft Excel Workers' compensation Anesthesia benefit verification Experience in a procedural specialty such as pain management, orthopedics, surgery, or in an ambulatory surgery setting is especially helpful. What We're Looking For This is a high-volume position that requires excellent organization and consistent follow-through. Candidates should be comfortable managing multiple patients and pending requests at different stages of the authorization process. The right person will be comfortable communicating with insurance companies, researching payer requirements, navigating insurance portals, discussing financial responsibility with patients, and following up on outstanding authorization requests. Submitting an authorization is only the first step. Pending requests must be actively monitored until a determination is received, reviewed for accuracy, documented, and communicated appropriately. Strong attention to detail is essential because authorization errors can result in procedure delays, denials, or unexpected costs for patients. Benefits Paid holidays Paid time off Competitive hourly pay Opportunities for professional growth If you have hands-on experience with medical insurance verification and procedure authorizations and enjoy taking ownership of the clearance process from beginning to end, we encourage you to apply.

Pay:

$21.00 - $24.00 per hour Expected hours: 40.0 per week

Benefits:

Employee discount Paid time off

Work Location:

In person