Healthcare Authorization Pro - Fast Verifications

Lehigh Valley Health Network, Inc.; Allentown (Lehigh County); On-site; USD 42,000 - 54,000; Full time

Job summary

Lehigh Valley Health Network, Inc. is seeking an Authorization Specialist to obtain authorizations for surgical procedures, diagnostic testing, medications, and referrals.

The role collaborates with physicians and office staff to determine medical necessity and ensures timely billing by verifying coverage. The position requires a High School Diploma or GED with specialized training in insurance, coding, billing, or a related program, plus at least 1 year in a healthcare setting handling

Qualifications

• Minimum qualifications include a high school diploma or GED with specialized training in insurance, coding, billing, or a related healthcare program.
• One year in a healthcare setting with insurance verification/authorizations is required.
• Familiarity with billing procedures and payer reimbursement and knowledge of patient rights (HIPAA).
• Proficiency in utilization management processes and standard medical practices.

Responsibilities

• Obtains authorizations for surgical procedures, diagnostic testing, medications, and referrals.
• Collaborates with physicians and office staff to determine medical necessity and treatment plans.
• Performs insurance verification and precertification communications with payers.
• Maintains compliance with network policy and communicates any missing authorizations.

Skills

Insurance verification

Authorization

Billing procedures

HIPAA knowledge

Education

High School Diploma/GED

Job description

Lehigh Valley Health Network, Inc. is seeking an Authorization Specialist to obtain authorizations for surgical procedures, diagnostic testing, medications, and referrals.

The role collaborates with physicians and office staff to determine medical necessity and ensures timely billing by verifying coverage. The position requires a High School Diploma or GED with specialized training in insurance, coding, billing, or a related program, plus at least 1 year in a healthcare setting handling