Insurance Authorization Specialist
Solaris Health
full-time
Posted on:
Location Type: Remote
Location: United States
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Job Level
About the role
- The Insurance Authorization Specialist is responsible for securing insurance authorizations for medical services to ensure timely patient care and accurate reimbursement.
- Initiate and track insurance prior authorizations for scheduled procedures, imaging, and other medical services.
- Verify insurance eligibility and benefits using payer portals or through direct contact with payers.
- Accurately document authorization statuses in the electronic medical record (EMR) and Practice Management (PM) system.
- Ensure all authorizations are obtained prior to the scheduled date of service to avoid delays or denials.
- Work closely with the Manager/Supervisor and Team Lead of Financial Clearance to escalate urgent or complex authorization cases.
- Support team objectives and contribute to departmental huddles and workflow optimization initiatives.
- Participate in ongoing training and feedback sessions led by the Supervisor to enhance performance and process compliance.
- Communicate with insurance carriers to gather necessary clinical documentation and follow up on pending requests.
- Identify and report recurring payer issues or trends to the Supervisor for team-level resolution or escalation.
- Inform patients of authorization status, potential delays, and what to expect if coverage issues arise.
- Coordinate with patient estimation staff to ensure authorizations align with cost estimates and pre-service collections efforts.
Requirements
- High School Diploma or equivalent required
- Associate’s degree in healthcare administration, billing, or related field preferred
- Minimum 1 year of experience in medical office, insurance verification, or healthcare billing
- Comprehensive understanding of insurance verification, contract benefits and medical terminology
- Ability to follow policies and procedures and enter data into various electronic systems while maintaining the integrity and accuracy of the data
- Professional verbal and written communication skills
- Proficient in payer portals, EMR systems, and Microsoft Office
- Excellent organizational skills and attention to detail
- Excellent customer service skills
- Strong analytical and problem-solving skills
Benefits
- 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
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills & Tools
insurance authorizationsinsurance verificationmedical terminologydata entrybillingpayer portalselectronic medical record (EMR)Practice Management (PM) systemanalytical skillsproblem-solving skills
Soft Skills
verbal communicationwritten communicationorganizational skillsattention to detailcustomer serviceteam collaborationworkflow optimizationtraining participationescalation of issuespatient communication