Healthcare Insurance Verification & Authorization Specialist

Northern Light Health; Brewer (ME); On-site; USD 26,000 - 37,000; Full time

Job summary

Northern Light Eastern Maine Medical Center in Brewer, ME, is seeking a Financial Review Specialist to manage insurance verification, PCP referrals, medical necessity screening and prior authorizations for outpatient infused therapies and imaging.

The role requires coordinating with the Financial Counselor and Scheduling to ensure service coverage, educating staff on verification software, and performing quality audits. Associated degree is required.

Qualifications

• Required Associate's Degree.

Responsibilities

• Coordinate day-to-day operations for insurance verification, PCP referrals, and prior authorizations for outpatient infused drugs and imaging.
• Serve as liaison between staff, Financial Counselor, Scheduling and Check-In to ensure coverage of all services.
• Educate staff on insurance verification software, including securing access and QA post-implementation.
• Conduct periodic quality audits of routine transactions.
• Onboard new insurance verification staff using a skills assessment tool.
• Assist Revenue Cycle team with process improvement.
• Cover insurance verification, PCP referral, medical necessity screening and prior authorization functions as needed.

Skills

Insurance verification

PCP referrals

Medical necessity screening

Prior authorizations

Education

Associate's degree

Job description

Northern Light Eastern Maine Medical Center in Brewer, ME, is seeking a Financial Review Specialist to manage insurance verification, PCP referrals, medical necessity screening and prior authorizations for outpatient infused therapies and imaging.

The role requires coordinating with the Financial Counselor and Scheduling to ensure service coverage, educating staff on verification software, and performing quality audits. Associated degree is required.