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 other medical services.

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

• Accurately document authorization statuses in the electronic medical record and Practice Management system.

• Ensure that authorizations are secured 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.

• Support team goals and actively participate in departmental huddles and workflow optimization efforts.

• Engage in ongoing training and feedback sessions.

• Communicate with insurance carriers to obtain clinical documentation and follow up on pending requests.

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

• Inform patients about authorization status, possible delays, and coverage concerns.

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

• Adhere to ethical standards, relevant laws, regulations, the Solaris Health Code of Conduct, and organizational policies.

• Maintain confidentiality of protected health information in accordance with HIPAA regulations.

• Report suspected concerns or violations and complete Annual Compliance Training.

• Carry out other position-related responsibilities as assigned.

⛳️ Requirements

• High School Diploma or equivalent is required.

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

• Thorough understanding of insurance verification, contract benefits, and medical terminology.

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

• Professional verbal and written communication skills.

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

• Exceptional organizational skills and attention to detail.

• Strong customer service skills.

• Solid analytical and problem-solving abilities.

• Ability to work effectively under supervision and in a collaborative, team-oriented setting.

• Capacity to manage multiple authorizations concurrently.

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

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

🏝️ Benefits

• PTO

• Holiday pay

• 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