Join a dedicated healthcare team in the Midwest region as an Authorization Specialist responsible for verifying patient insurance eligibility and securing prior authorizations before scheduled exams. This role ensures smooth coordination between patients, providers, and insurance payers to facilitate timely care.

Key Responsibilities

• Obtain prior authorizations and precertifications for surgical, laboratory, and diagnostic imaging procedures.
• Manage multiple authorization requests efficiently and accurately.
• Document authorization decisions in clinical software following established policies.
• Communicate with insurance payers via phone and online portals to verify benefits and authorization status.
• Confirm member plan eligibility prior to processing requests.
• Utilize clinical knowledge and resources to support authorization processes.

Education

High school diploma or equivalent required. Completion of a Registered Medical Assistant or Licensed Practical Nurse program is preferred.

Experience

At least one year of clinical experience in a healthcare setting is required. Experience with insurance verification and prior authorization processes is preferred. Familiarity with medical terminology and CPT & ICD-9/10 coding is advantageous.

Certification and Licensure

Valid Licensed Practical Nurse (LPN) license from Missouri or a Compact State, or accreditation as a Registered Medical Assistant is required if applicable.

Mental and Physical Requirements

Strong communication skills, both verbal and written, with the ability to understand and convey detailed information. Ability to maintain concentration during repetitive tasks. Physical ability to stand, walk, sit, and reach as needed.

Working Conditions

Standard office environment with occasional exposure to noise, fumes, chemicals, and other workplace hazards.