Healthcare Authorization & Verification Specialist

Ohio-Ent-; Columbus (OH); On-site; USD 42,000 - 52,000; Full time

Benefits offered by this job

Medical, dental, vision

Paid time off

Paid holidays

401k

Short/long-term disability

Life insurance

Weekday schedule

Job summary

Ohio-Ent- seeks a highly organized Pre-Certification Specialist to obtain insurance authorizations and verify patient benefits, ensuring services are approved before treatment.

This role acts as a liaison among patients, providers, and insurance carriers to meet payer requirements, minimize denials, and support a positive patient experience. Monday–Friday schedules and comprehensive benefits are offered.

Qualifications

• 1–3 years of healthcare authorization or insurance verification experience.
• Experience with multiple commercial insurers, Medicare, and Medicaid.
• Experience in a physician practice, outpatient clinic, hospital, or specialty healthcare setting.
• Understanding of insurance plans and medical necessity guidelines.
• Proficient with ICD-10 & CPT codes.
• Excellent oral and written communication skills.
• Experience with EMR and practice management systems.

Responsibilities

• Verify patient insurance eligibility, benefits, and coverage.
• Obtain prior authorizations and pre-certifications for procedures, diagnostics, and specialty services.
• Review orders and documentation for authorization requirements.
• Submit authorization requests and medical records to insurance carriers.
• Monitor approvals, denials, and expirations.
• Follow up on pending requests to ensure timely completion.
• Communicate authorization status and patient financial responsibility to providers, staff, and patients.
• Assist with appeals and reconsideration requests for denied services.
• Maintain documentation in EMR and practice management systems.
• Collaborate with scheduling, clinical, and billing to reduce delays and support revenue cycle.

Skills

Organizational skills

Attention to detail

Excellent communication

Interpersonal skills

Liaison/coordination

Tools

EMR

Practice management systems

Job description

Ohio-Ent- seeks a highly organized Pre-Certification Specialist to obtain insurance authorizations and verify patient benefits, ensuring services are approved before treatment.

This role acts as a liaison among patients, providers, and insurance carriers to meet payer requirements, minimize denials, and support a positive patient experience. Monday–Friday schedules and comprehensive benefits are offered.