Healthcare Authorization Specialist - Payer Liaison

Wmchealth; New York (NY); On-site; USD 42,000 - 64,000; Full time

Job summary

Wmchealth is seeking an Authorization Specialist in New York to verify insurance information and obtain authorizations for hospital procedures, tests, and office diagnostics. The role ensures timely processing, prevents treatment delays, and protects patient information confidentiality across multiple locations.

The ideal candidate has 1–3 years in health care with experience in pre-authorization, and a high school diploma or equivalent.

Qualifications

• 1-3 years of experience in the health care field is required.
• Previous experience with the pre-authorization process preferred.
• A high school diploma or equivalency required.

Responsibilities

• Serves as liaison between physicians, office staff, patients and insurance carriers regarding the authorization process.
• Collects and reviews patient demographic and insurance data for accuracy as part of the authorization process.
• Collects and submits documentation and diagnosis needed for authorizations.
• Advises physicians and coordinators on problems with insurance authorizations and resubmits requests with additional or revised information as needed.
• Notifies providers of need for peer-to-peer reviews for denials and assists with arranging them.
• Provides daily follow-up with authorization departments of insurance carriers for status updates to ensure timely service delivery.
• Performs eligibility checks on payer websites and internal systems.
• Utilizes automated systems to manage work assignments.
• Reviews schedules to capture changes and add-on testing across locations.
• Logs delivery of medications from Specialty pharmacies and notifies appropriate person via EMR.
• Performs other tasks as assigned.

Education

High School Diploma or Equivalent

Job description

Wmchealth is seeking an Authorization Specialist in New York to verify insurance information and obtain authorizations for hospital procedures, tests, and office diagnostics. The role ensures timely processing, prevents treatment delays, and protects patient information confidentiality across multiple locations.

The ideal candidate has 1–3 years in health care with experience in pre-authorization, and a high school diploma or equivalent.