Join a dedicated healthcare team in the heart of the Midwest region, where your role as an Insurance Verification Specialist will be vital in ensuring patients receive timely and accurate insurance prior authorizations. This full-time, day shift position involves verifying patient eligibility, determining benefits, and securing prior authorizations before scheduled exams.

Key Responsibilities

• Obtain or assist in obtaining prior authorizations and precertifications from insurance payers for surgical, laboratory, and diagnostic imaging procedures.
• Efficiently manage multiple prior 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. Preferred candidates will have graduated from a Registered Medical Assistant or Licensed Practical Nurse program.

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

A valid Licensed Practical Nurse license from Missouri or a Compact State, or accreditation as a Registered Medical Assistant, is required if applicable. Strong communication skills, both verbal and written, are essential. Candidates must be able to maintain concentration during repetitive tasks and have the 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 typical in healthcare settings.