Solaris Health

Solaris Health is a national healthcare platform to enhance access to specialty healthcare and improve patient outcomes.

Insurance Authorization Specialist

InsuranceInsuranceFull TimeRemoteTeam 1,001-5,000Since 2020H1B No SponsorCompany SiteLinkedIn

Location

United States

Posted

34 days ago

Salary

Not specified

High School1 yr expEnglish

Job Description

• The Insurance Authorization Specialist is responsible for securing insurance authorizations for medical services to ensure timely patient care and accurate reimbursement. • Initiate and track insurance prior authorizations for scheduled procedures, imaging, and other medical services. • Verify insurance eligibility and benefits using payer portals or through direct contact with payers. • Accurately document authorization statuses in the electronic medical record (EMR) and Practice Management (PM) system. • Ensure all authorizations are obtained prior to the scheduled date of service to avoid delays or denials. • Work closely with the Manager/Supervisor and Team Lead of Financial Clearance to escalate urgent or complex authorization cases. • Support team objectives and contribute to departmental huddles and workflow optimization initiatives. • Participate in ongoing training and feedback sessions led by the Supervisor to enhance performance and process compliance. • Communicate with insurance carriers to gather necessary clinical documentation and follow up on pending requests. • Identify and report recurring payer issues or trends to the Supervisor for team-level resolution or escalation. • Inform patients of authorization status, potential delays, and what to expect if coverage issues arise. • Coordinate with patient estimation staff to ensure authorizations align with cost estimates and pre-service collections efforts.

Job Requirements

  • High School Diploma or equivalent required
  • Associate’s degree in healthcare administration, billing, or related field preferred
  • Minimum 1 year of experience in medical office, insurance verification, or healthcare billing
  • Comprehensive understanding of insurance verification, contract benefits and medical terminology
  • Ability to follow policies and procedures and enter data into various electronic systems while maintaining the integrity and accuracy of the data
  • Professional verbal and written communication skills
  • Proficient in payer portals, EMR systems, and Microsoft Office
  • Excellent organizational skills and attention to detail
  • Excellent customer service skills
  • Strong analytical and problem-solving skills

Benefits

  • Health insurance
  • Dental insurance
  • Vision insurance
  • Life Insurance
  • Pet Insurance
  • Health savings account
  • Paid sick time
  • Paid time off
  • Paid holidays
  • Profit sharing
  • Retirement plan

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