Insurance Authorization Specialist

Founded in 2003, this organization provides intelligent solutions to optimize revenue cycle operations, administrative workflows, care coordination, and clinical research within healthcare. It serves more than 350 healthcare organizations across the United States, India, Colombia, and the Philippines, supporting providers, payers, life science companies, medical device manufacturers, health technology firms, and researchers with technology, specialty expertise, and operational support.

About the Opportunity

The Insurance Authorization Specialist plays a critical role in managing benefits, eligibility, and prior authorizations for hospitals and physicians. This position acts as a key intermediary between medical institutions, patients, and insurance agencies to ensure accurate information, optimize reimbursement, and reduce financial risk. The role supports pre-registration processes and financial arrangements for patient accounts across multiple affiliates.

Responsibilities

• Maintain assigned work queues and reports.
• Perform eligibility checks and verify insurance benefits for inpatient and outpatient visits.
• Collect and record accurate demographic, clinical, and insurance data by contacting patients, families, and physicians.
• Update system information to support verification and billing accuracy.
• Refer patients needing payment plans to cash posting specialists.
• Comply with corporate policies and regulatory standards including EMTALA, HIPAA, and HIPAA HITECH.
• Perform additional related tasks as assigned to meet operational needs.

Requirements

• High school diploma or equivalent.
• 1-2 years of experience in medical billing, coding, patient access, or a medical clinic environment.
• Understanding of hospital/physician billing and terminology (e.g., CPT, ICD-10, co-pays).
• Customer service experience in a diverse environment.

Qualifications

• Preferred: Experience with third-party payers, collections, insurance verification systems.
• Preferred: Familiarity with coding rules from AHIMA, AMA, AHA, and CMS.

Benefits

• Health, dental, and vision coverage.
• Voluntary insurance options.
• 401(k) plan with employer match.
• Professional development opportunities.
• Paid time off and holiday pay.
• Eligibility for bonus programs, commissions, or other variable incentives may vary.