Insurance Verification & Authorization Specialist

Insurance Verification & Authorization Specialist

Job Summary

The Insurance Verification Specialist is responsible for verifying patient insurance coverage and obtaining required authorizations for patient orders. This role ensures accurate insurance information, timely approvals, while reducing denials and improving revenue.

Key Responsibilities

• Verify patient insurance eligibility, benefits, and coverage details
• Obtain prior authorizations for patient orders
• Communicate with insurance companies to confirm coverage and authorization status
• Work closely with staff to resolve insurance issues
• Document verification and authorization details accurately in the system
• Follow up on pending authorizations to ensure timely approval

Work Details

• Employment type: Full-time in office
• Schedule: Monday–Friday
• Location: Yardley, PA

Requirements

Desired Minimum Qualifications

• Experience with insurance verification, prior authorizations, or medical billing
• Knowledge of medical insurance plans, including Medicare, Medicaid, Managed care and Commercial payers
• Strong attention to detail and organizational skills
• Ability to communicate clearly with insurance representatives and internal teams
• Proficiency in HCPC coding, ICD-10 coding, and allowable.
• Proficient in computer systems, including advanced knowledge of medical billing software applications.