Insurance Authorization Specialist

This is a fully remote position, open to applicants in United States.

📋 Description

• Initiate and monitor insurance prior authorizations for scheduled procedures, imaging, and various medical services.

• Verify insurance eligibility and benefits through payer portals or direct engagement with payers.

• Accurately document authorization statuses in the EMR and Practice Management system.

• Secure authorizations prior to scheduled service dates to prevent delays or denials.

• Escalate urgent or complex authorization cases to the Manager/Supervisor and Team Lead of Financial Clearance.

• Contribute to team goals and engage in departmental huddles and workflow optimization activities.

• Participate in continuous training and feedback sessions.

• Communicate with insurance carriers to collect clinical documentation and follow up on outstanding requests.

• Identify and report recurring issues or trends with payers to the Supervisor.

• Inform patients about authorization statuses, potential delays, and coverage concerns.

• Collaborate with patient estimation staff to ensure authorizations align with cost estimates and pre-service collections.

• Execute other related duties as assigned.

• Uphold ethical standards, applicable laws, HIPAA regulations, the Solaris Health Code of Conduct, and organizational policies.

• Report any suspected compliance issues or violations.

• Complete Annual Compliance Training.

⛳️ Requirements

• High School Diploma or equivalent is required.

• An Associate’s degree in healthcare administration, billing, or a related field is preferred.

• At least 1 year of experience in a medical office, insurance verification, or healthcare billing is necessary.

• Familiarity with payer rules, authorization requirements, and EMR documentation is preferred.

• A comprehensive understanding of insurance verification, contract benefits, and medical terminology is essential.

• Ability to adhere to policies and procedures while entering data into various electronic systems, ensuring data integrity and accuracy.

• Professional verbal and written communication skills are required.

• Proficiency in payer portals, EMR systems, and Microsoft Office is necessary.

• Excellent organizational skills and attention to detail are essential.

• Strong customer service skills are required.

• Robust analytical and problem-solving abilities are necessary.

• Must be able to work effectively under supervision and thrive in a collaborative, team-oriented environment.

• Detail-oriented and organized, with the capability to manage multiple authorizations simultaneously.

• Must maintain patient confidentiality in accordance with HIPAA.

• Compliance with applicable laws, regulations, the Solaris Health Code of Conduct, and organizational policies and procedures is required.

• Completion of Annual Compliance Training is mandatory.

🏝️ Benefits

• Competitive pay.

• PTO.

• Holiday pay.

• Comprehensive benefits package.

• Health insurance.

• Dental insurance.

• Vision insurance.

• Life Insurance.

• Pet Insurance.

• Health savings account.

• Paid sick time.

• Paid time off.

• Paid holidays.

• Profit sharing.

• Retirement plan.

• No weekends.

• No evenings.

• No holidays.