Join a dedicated healthcare team in the heart of the Midwest region, where your role as an Insurance Verification and Prior Authorization Specialist is vital to patient care coordination. This position involves verifying patient insurance eligibility, determining benefits, and securing prior authorizations before scheduled exams.

Key Responsibilities

• Obtain prior authorizations and precertifications from insurance payers for surgical, laboratory, and diagnostic imaging procedures.
• Efficiently manage multiple authorization requests simultaneously with accuracy.
• Document authorization decisions in clinical software following established policies.
• Communicate with insurance providers 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.

Requirements

Must hold a valid Licensed Practical Nurse license from Missouri or a Compact State, or be an accredited Registered Medical Assistant if applicable. Strong communication skills, attention to detail, and the ability to manage repetitive tasks with concentration are essential. Physical ability to stand, walk, sit, and reach as needed.

Working Conditions

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

Become part of a supportive healthcare team serving a broad six-county area in the Midwest, committed to growth and excellence in patient care.