Job Summary We are seeking a EXPERIENCED, detail-oriented Medical Authorization Specialist to join our healthcare team. The ideal candidate will be responsible for managing prior authorization requests, verifying insurance coverage, and ensuring compliance with healthcare regulations. This role requires strong knowledge of managed care processes, medical terminology, and medical coding systems such as CPT, ICD-9, ICD-10, and ICD coding. The position offers an opportunity to work in a professional medical environment with a focus on accuracy and confidentiality. Duties Review and process prior authorization requests for various medical procedures and services. Verify insurance coverage and benefits for patients in accordance with managed care policies. Maintain accurate and complete medical records, ensuring HIPAA compliance at all times. Utilize medical coding systems including CPT, ICD-9, ICD-10, and ICD coding to accurately document procedures and diagnoses. Collaborate with healthcare providers to obtain necessary documentation for authorization approvals. Ensure timely submission of authorization requests and follow-up on pending cases. Assist with insurance verification processes to confirm patient eligibility and benefits. Maintain detailed documentation of all authorization activities in the medical office system. Stay updated on healthcare regulations, insurance policies, and coding changes relevant to the role. Qualifications Proven experience in referral and authorization, or a related healthcare setting. Strong knowledge of HIPAA regulations and confidentiality standards. Familiarity with CPT coding, ICD-9, ICD-10, and ICD coding systems. Experience with medical records management and medical terminology. Prior experience in insurance verification. Excellent organizational skills with attention to detail and accuracy. Ability to work independently while collaborating effectively with healthcare providers and insurance companies. Medical Office experience with proficiency in electronic health records (EHR) systems is mandatory.

Pay:

$18.00 - $20.00 per hour

Benefits:

Paid time off

Work Location:

In person