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Administrative
Medical Biller
Algona, IA

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KOSSUTH REGIONAL HEALTH CENTER

AUTHORIZATION REPRESENTATIVE

Job Description

Authorization Representative Part Time - 48 hours per pay period Remote work option available following required training Join our team as an Authorization Representative, where you'll play a critical role in helping patients access the care they need. In this position, you'll work closely with providers, clinical staff, and insurance payers to obtain and manage prior authorizations, navigate coverage requirements, and ensure services are approved in a timely manner. We're looking for a detail-oriented professional who thrives in a fast-paced healthcare environment and is committed to delivering exceptional support while maintaining regulatory compliance.
What You'll Do:
Submit & manage prior authorization requests through insurance portals, phone, & fax Gather & submit required clinical documentation, orders, and coding information Track authorization statuses, expirations, denials, & follow-up actions in the EMR Verify required authorizations are in place before scheduled services Stay current on payer requirements, authorization guidelines, and workflow changes Support compliance, audit, and HIPAA-related requirements
What We're Looking For:
High School Diploma or GED required 1+ year of experience in a medical office or clinical setting Prior authorization, insurance, or medical billing experience preferred Knowledge of medical terminology, insurance benefits, & authorization processes Experience with EMRs & insurance portals (e.g. Availity, Anthem, Carelon, eviCore) preferred Strong communication, organization, & customer service skills Ability to manage multiple priorities, meet deadlines, & maintain attention to detail Collaborative, dependable, & committed to delivering a positive patient experience Selected applicant will be required to complete a drug test, immunizations, vaccinations, background check and other health tests.