Revenue Authorization Specialist

Employment Type: Full time

About the Role

Responsible for all aspects of the authorization/pre-certification or referral process. Verifies insurance eligibility and contacts the payer to initiate pre-certification by providing supporting medical documentation. Follows up with insurance on the outcome of determination for all medical procedures and services in an attempt to obtain a successful authorization. Specializes in Cardiology and Neurology.

Schedule

Monday - Friday, 9:00 AM - 5:30 PM

Responsibilities

• Assists offices in resolving billing discrepancies and any other referral/authorization issues.
• Contacts insurance companies via appropriate methods and obtains pre-certifications and authorizations.
• Obtains urgent authorizations same day or next day.
• Verifies correct procedural and diagnostic codes and insurance verification.

Requirements

• High school diploma.
• One (1) to three (3) years of experience with insurance referrals, prior authorizations, or other equivalent knowledge of professional revenue cycle.
• Knowledge of medical terminology and procedures at the level needed to perform responsibilities.

Benefits

• Competitive compensation and benefits packages including medical, dental, and vision with coverage starting on day one.
• Retirement savings account with employer match starting on day one.
• Generous paid time off programs.
• Employee recognition programs.
• Tuition/professional development reimbursement starting on day one.
• RN to BSN tuition 100% paid at Mount Carmel’s College of Nursing.
• Relocation assistance (geographic and position restrictions apply).
• Employee Referral Rewards program.
• DailyPay – access to earned wages before payday.
• Opportunity to join Diversity, Equity, and Inclusion Colleague Resource Groups.

Mount Carmel Health System was recognized by Forbes in 2025 as one of America’s Best State Employers.