Pre-Authorization Verification Specialist

JEWISH FAMILY AND CHILDRENS SERVICE INC - 3.8

Mesa, AZ Job Details $17.50 - $18.50 an hour 1 hour ago Qualifications HIPAA compliance Medicare Medical insurance coverage verification Customer service HIPAA Care documentation High school diploma or GED Medicaid health insurance Medicaid regulations Medicaid Full Job Description JFCS is seeking a detail-oriented professional to join our team in a role focused on supporting patients and ensuring a smooth process for accessing healthcare services. This position involves working closely with patients, insurance providers, and internal teams to help ensure information is accurate and services are appropriately coordinated. Obtains and updated copies of patients' insurance cards and demographic information. Determines and verifies patient insurance eligibility, benefits, and coverage for AHCCCS, Medicaid, Medicare and third-party insurance coverage. Engages with patients to determine if services requested need prior authorization. Submits authorization requests and tracks approvals to ensure timely patient care. Communicates with insurance companies to resolve authorization issues and claim denials. Maintains accurate patient insurance records in the electronic medical record (EMR) system. Qualifications Previous experience as an Eligibility Specialist and demonstrated ability to manage multiple insurance plans including third-party insurance, AHCCCS, Medicaid and Medicare plans. Capacity to work with clinical staff, providers and follow payer guidelines and HIPAA regulations Ability to work in a fast-paced environment and provide excellent customer service and maintain documentation accuracy. Bilingual Strongly Preferred Must Receive/Maintain DPS Fingerprint Clearance High School Diploma or GED Must be able to perform the essential functions of the job including prolonged sitting and in certain positions driving, lifting 20lbs, walking, standing, and executing dexterity with a keyboard or smart pad.