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KS
Kudzu Staffing
Medical Authorization Specialist
Career Insights for Medical Claims Processor / Representative
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Based on South Carolina data
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What they do
A Medical Claims Processor or Representative reviews and processes medical insurance claims and determines whether an insurance policy will cover a medical procedure. Gathers information from policy holders and organizes insurance files; may process checks with payments to policy holders when a medical claim is approved.
$45,209 / year median in South Carolina
-3% projected decline
Job Description
Minimum 1 Year experience as an Medical Authorization Specialist Kudzu Staffing is currently seeking an experienced Medical Authorization Specialist to fill an opening with a healthcare provider located in Columbia, SC. The ideal candidate should have prior experience obtaining authorizations and precertifications from insurance companies for imaging procedures such as MRI, CT, Ultrasounds, and PET Scans. Requirements of the Medical Authorization Specialist
- High School diploma or GED (Associate's degree in Healthcare Administration or related field preferred)
- Minimum 1 year of prior authorization/precertification experience in a medical office, imaging center, or hospital setting
- Knowledge of insurance company requirements and medical terminology
- Strong computer skills and ability to navigate EMR systems
- Excellent communication and organizational skills
- Reliable transportation
- Pass a background check and drug test Benefits of the Medical Authorization Specialist position
- Excellent pay
- Monday - Friday schedule
- Medical / Dental / Vision Responsibilities of the Medical Authorization Specialist
- Obtain prior authorizations and precertification's from insurance companies for MRI, CT, Ultrasounds, and PET Scans
- Verify patient insurance coverage and eligibility
- Accurately document authorization details into EMR system
- Communicate with patients, physicians, and insurance companies to resolve issues promptly
- Ensure authorizations are obtained in a timely manner to avoid appointment delays
- Work closely with scheduling and billing departments to support patient care