Insurance Verification and Authorization Specialist

This is a remote position.

KEY RESPONSIBILITIES

Insurance Verification & Eligibility

• Verify patient insurance eligibility and benefits prior to all scheduled appointments
  
• Confirm coverage details including co-pays, co-insurance, deductibles, out-of-pocket maximums, and coverage limitations
  
• Identify and document patient financial responsibility at least 24 hours before patient arrival
  
• Update patient files and EMR records with accurate, complete insurance and eligibility information
  
• Communicate verification results clearly to clinical and administrative staff
  
• Handle a broad range of insurance types including commercial plans, Medicare, Medicaid, workers' compensation, and auto claims
  

Prior Authorization & Authorization Management

• Obtain prior authorizations for procedures, therapy visits, and services as required by insurance plans
  
• Submit authorization requests via phone, payer portals, and electronic systems in a timely manner
  
• Track authorization approvals, denials, pending requests, and expiration dates in an organized manner
  
• Follow up proactively on pending authorizations to prevent gaps in care or appointment cancellations
  
• Renew authorizations as ongoing treatment requires and maintain complete records of all authorization activity
  
• Escalate unresolved authorization issues to the appropriate internal team member promptly
  

Payer Communication & Issue Resolution

• Liaise directly with insurance companies via phone and payer portals to clarify coverage, resolve discrepancies, and obtain benefit details
  
• Assist patients and clinical staff with insurance-related questions and benefit explanations
  
• Identify and help prevent claim rejections caused by inaccurate or incomplete insurance information
  
• Assist billing teams with insurance-related documentation, claim support, and records retrieval as needed
  

Documentation & Administrative Support

• Maintain accurate, organized electronic patient records and insurance documentation in the EMR
  
• Type, upload, and manage patient forms and insurance-related documents
  
• Process and organize incoming faxes, referrals, and payer correspondence
  
• Generate basic reports and tracking logs to support verification workflow oversight
  
• Maintain strict HIPAA compliance and patient confidentiality at all times
  
• Participate in team meetings, training sessions, and check-ins as required by the client
  
  
  
  

Requirements

Benefits