Join a dedicated healthcare team in the heart of the Midwest region, where your role as an Authorization Specialist will be vital in ensuring patients receive timely and accurate insurance verification and prior authorization services. This position focuses on verifying patient eligibility, determining benefits, and securing necessary insurance approvals before scheduled exams.

Essential Duties and Responsibilities

• Obtain or assist in obtaining prior authorization and precertification from insurance payers for surgical, laboratory, and diagnostic imaging procedures.
• Efficiently process multiple patient authorization requests simultaneously with accuracy.
• 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 and benefits 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.

Requirements

• Strong oral and written communication skills with attention to detail.
• Ability to concentrate for extended periods and perform repetitive tasks.
• Physical ability to stand, walk, sit, and reach as needed.
• Comfort working in a standard office environment with occasional exposure to noise and other minor hazards.

This role offers an opportunity to contribute meaningfully to patient care coordination within a supportive and growth-oriented healthcare environment serving a broad regional community in the Midwest.