Pre-Authorization Verification Specialist

About the role

JFCS is seeking a detail-oriented professional to join our team in a role focused on supporting patients and ensuring a smooth process for accessing healthcare services. This position involves working closely with patients, insurance providers, and internal teams to help ensure information is accurate and services are appropriately coordinated.

Responsibilities

• Obtains and updates copies of patients' insurance cards and demographic information.
• Determines and verifies patient insurance eligibility, benefits, and coverage for AHCCCS, Medicaid, Medicare, and third-party insurance coverage.
• Engages with patients to determine if services requested need prior authorization.
• Submits authorization requests and tracks approvals to ensure timely patient care.
• Communicates with insurance companies to resolve authorization issues and claim denials.
• Maintains accurate patient insurance records in the electronic medical record (EMR) system.

Requirements

• Previous experience as an Eligibility Specialist and demonstrated ability to manage multiple insurance plans including third-party insurance, AHCCCS, Medicaid, and Medicare plans.
• Capacity to work with clinical staff, providers, and follow payer guidelines and HIPAA regulations.
• Ability to work in a fast-paced environment and provide excellent customer service while maintaining documentation accuracy.
• Bilingual strongly preferred.
• Must receive/maintain DPS Fingerprint Clearance.
• High School Diploma or GED.
• Must be able to perform the essential functions of the job including prolonged sitting, driving, lifting 20 lbs, walking, standing, and executing dexterity with a keyboard or smart pad.