Healthcare Authorization & Eligibility Specialist

Women s Wellness Place; City of Syracuse (NY); On-site; USD 28,000 - 29,000; Full time

Job summary

Evolving Solution Services in Syracuse, NY is seeking an Authorization and Eligibility Specialist to verify client eligibility, process authorization requests, and collaborate with providers and insurers to secure approvals.

The role requires attention to regulatory requirements, strong communication, and accurate record-keeping to minimize delays and denials while ensuring clients access needed care.

Qualifications

• High school diploma or equivalent; associate degree or higher preferred.
• Experience in healthcare administration, insurance verification, or a related field.
• Strong knowledge of insurance authorization processes and eligibility criteria.
• Proficiency with electronic health records (EHR) systems and standard office software.
• Excellent communication and organizational skills.

Responsibilities

• Review and verify client eligibility for various healthcare services and insurance benefits.
• Process and submit authorization requests to insurance providers and follow up on pending approvals.
• Maintain accurate and up-to-date records of authorizations, denials, and appeals in compliance with organizational and regulatory standards.
• Communicate with healthcare providers, insurance companies, and clients to resolve authorization issues and clarify coverage details.
• Monitor changes in insurance policies and regulations to ensure ongoing compliance and update internal procedures accordingly.

Skills

Healthcare administration experience

Insurance authorization knowledge

EHR proficiency

Office software proficiency

Excellent communication

Organizational skills

Education

High school diploma or equivalent; associate degree or higher preferred

Tools

EHR systems

Office software

Job description

Evolving Solution Services in Syracuse, NY is seeking an Authorization and Eligibility Specialist to verify client eligibility, process authorization requests, and collaborate with providers and insurers to secure approvals.

The role requires attention to regulatory requirements, strong communication, and accurate record-keeping to minimize delays and denials while ensuring clients access needed care.