Job Description

Job Overview

We are seeking a detail-oriented and knowledgeable Medical Insurance Authorization Specialist to join our healthcare team. The ideal candidate will be responsible for managing insurance authorizations, verifying coverage, and ensuring compliance with healthcare regulations. This role requires strong familiarity with managed care processes, medical coding, and medical terminology, along with excellent organizational skills to facilitate smooth patient care operations. Prior experience in medical offices, dental offices, or in medical records management is highly desirable. The successful applicant will play a vital role in streamlining insurance processes and supporting the delivery of quality healthcare services.

5 years experience a must.

Responsibilities

Obtain prior authorization from insurance providers for various medical procedures and treatments Verify patient insurance coverage and benefits accurately before service delivery Review and interpret medical records, documentation, and referral information to support authorization requests Utilize CPT coding, ICD-9, ICD-10, and ICD coding to prepare accurate documentation for insurance submissions Ensure compliance with HIPAA regulations to protect patient confidentiality during all processes Communicate effectively with healthcare providers, insurance companies, and patients regarding authorization status Maintain detailed records of all authorization requests, approvals, denials, and follow-up actions Stay updated on changes in managed care policies and insurance requirements to ensure ongoing compliance Assist with medical office tasks related to insurance verification and documentation as needed

Skills

Strong knowledge of managed care procedures and insurance verification processes Proficiency in medical office software and familiarity with medical records management systems Expertise in HIPAA regulations to ensure patient privacy and data security Experience with CPT coding, ICD-9, ICD-10, and ICD coding standards for accurate billing and documentation Excellent understanding of medical terminology and healthcare documentation practices Ability to interpret complex medical records and translate them into appropriate insurance claims or authorizations Prior experience in dental or general medical office environments is preferred Strong organizational skills with attention to detail to manage multiple authorization requests efficiently Effective communication skills for liaising between providers, insurers, and patients
This position offers an opportunity to contribute significantly to the efficiency of healthcare operations while ensuring compliance with industry standards. We welcome candidates who are committed to accuracy, confidentiality, and providing excellent support within a dynamic healthcare setting.

Job Type: Full-time

Pay: $24.11 - $29.03 per hour

Expected hours: 40 per week

Benefits:

401(k) Disability insurance Flexible schedule Health savings account Referral program
Experience:

medical insurance : 5 years (Required)
Work Location: In person