Insurance Verification & Authorization Specialist (Medical Office – In-Office)

Job Overview
We are seeking a motivated and detail-oriented Insurance Verification & Authorization Specialist to join our medical office team in a dynamic in-office environment. In this vital role, you will be the first point of contact for verifying patient insurance coverage and securing necessary authorizations to ensure seamless patient care delivery. Your expertise will help streamline administrative processes, reduce claim denials, and enhance patient satisfaction. If you thrive in a fast-paced setting, possess strong knowledge of managed care and medical billing procedures, and are committed to maintaining confidentiality and accuracy, this is the perfect opportunity for you to make an impactful difference.

Key Responsibilities:

• Verify patient insurance coverage by contacting insurance providers and obtaining detailed benefit information
• Accurately determine eligibility, coverage limitations, copays, deductibles, and out-of-pocket expenses
• Secure prior authorizations for surgeries, imaging, and other medical services in a timely manner
• Communicate patient financial responsibilities (copays, deductibles, and coinsurance) to both patients and internal staff
• Collect copayments, deductibles, and coinsurance for office visits and surgical procedures
• Serve as a point of contact for patients regarding insurance-related questions and provide clear, professional guidance
• Collaborate closely with scheduling, billing, and clinical teams to ensure seamless patient care and workflow
• Follow up on pending authorizations and resolve insurance-related issues or discrepancies
• Maintain accurate documentation of all verification and authorization activities within the electronic system
• Assist with scanning and uploading paper medical records into the electronic health record (EHR) system as part of a software transition
• Provide backup phone support, including answering incoming calls and routing them appropriately
• Ensure compliance with insurance guidelines, policies, and regulatory requirements

Qualifications

• Proven experience working in a medical office setting with a focus on insurance verification and authorization processes.
• Strong knowledge of managed care plans, CPT coding, ICD-9/ICD-10 coding, and medical terminology.
• Familiarity with HIPAA regulations related to patient privacy and data security.
• Experience with medical records management and medical coding practices.
• Excellent communication skills for liaising with insurance companies, providers, and patients.
• Office experience with proficiency in electronic health records (EHR) systems or practice management software.
• A background in healthcare administration is highly valued. Join our dedicated team where your expertise will directly contribute to delivering exceptional patient care while ensuring administrative excellence!

Pay: $18.00 - $22.00 per hour

Benefits:

• Dental insurance
• Health insurance
• Paid time off
• Vision insurance

Work Location: In person