Medical Insurance Authorization Specialist

Job Summary We are seeking a proactive and detail-oriented Medical Insurance Authorization Specialist to join our healthcare team. In this vital role, you will be responsible for obtaining prior authorizations and approvals from insurance providers to ensure patients receive timely and necessary medical services. Your expertise in managed care, medical coding, and insurance verification will help streamline the authorization process, reduce denials, and enhance patient care. This position offers an exciting opportunity to work in a dynamic environment where your skills directly impact patient outcomes and operational efficiency. Responsibilities Review patient medical records, treatment plans, and clinical documentation to determine authorization requirements. Verify insurance coverage and eligibility using managed care systems and insurance portals. Prepare and submit prior authorization requests accurately, including all necessary supporting documentation. Utilize CPT (Current Procedural Terminology), ICD-9, ICD-10, and ICD coding to ensure precise coding for billing and authorization purposes. Follow up with insurance companies on pending authorizations, addressing any additional information requests promptly. Maintain detailed records of all authorization requests, approvals, denials, and appeals in accordance with HIPAA regulations. Collaborate with medical office staff, healthcare providers, and insurance representatives to facilitate smooth communication and expedite approvals. Requirements Proven experience in medical office administration or healthcare setting, preferably with dental or outpatient clinics. Strong knowledge of managed care processes, insurance verification procedures, and medical billing practices. Familiarity with HIPAA compliance standards to protect patient privacy and confidentiality. Proficiency in medical terminology, medical records management, and medical coding (CPT, ICD-9/10). Experience with insurance authorization workflows within managed care environments. Excellent organizational skills with attention to detail to handle multiple requests efficiently. Office experience involving electronic health records (EHR) systems or practice management software is highly desirable. Join us as a Medical Insurance Authorization Specialist and play a key role in ensuring our patients receive the care they need without delay! Your expertise will help improve operational workflows while providing exceptional support to our healthcare team.

Pay:

$16.00 - $18.00 per hour

Work Location:

In person