Insurance Authorization & Billing Specialist

UHC United Hospital Center; Bridgeport (WV); On-site; USD 34,000 - 52,000; Full time

Job summary

UHC United Hospital Center in Bridgeport, WV is seeking a detail-oriented insurance authorization specialist. You will identify patients needing pre-certification, verify coverage with insurers, and communicate self-pay portions to patients, using EPIC for scheduling, billing edits, and care transitions.

Responsibilities include medical necessity screening, documenting referrals, calculating anticipated charges, and assisting with denials and appeals as needed.

Qualifications

• High school diploma or equivalent.
• State criminal background check and Federal checks as required.
• Knowledge of ICD-10, CPT coding and payor processes.
• Experience with insurance pre-certification/pre-authorization is preferred.
• Strong communication and math skills for patient billing.

Responsibilities

• Identify patients needing pre-certification/pre-authorization.
• Follow up on accounts using system flags.
• Contact insurance or employer to verify eligibility/benefits.
• Explain self-pay portions and arrange financial resolution.
• Use EPIC queues for scheduling, transition of care, billing edits.
• Perform medical necessity screening per payor rules.
• Document referrals/authorization numbers in EPIC.
• Initiate charge anticipation calculations for anticipated charges.
• Communicate anticipated self-pay portions to patients.
• Refer self-pay patients to Financial Counselors for eligibility.
• Assist with denial management and appeals when needed.
• Flag workflow issues to management and resolve promptly.

Skills

Communication

Medical terminology

ICD-10 & CPT coding

Time of service collection

Customer service

Typing speed 25 wpm

Reading & comprehension

Education

High school diploma

Job description

UHC United Hospital Center in Bridgeport, WV is seeking a detail-oriented insurance authorization specialist. You will identify patients needing pre-certification, verify coverage with insurers, and communicate self-pay portions to patients, using EPIC for scheduling, billing edits, and care transitions.

Responsibilities include medical necessity screening, documenting referrals, calculating anticipated charges, and assisting with denials and appeals as needed.