Insurance Authorization & Billing Specialist

WVU Medicine; St. Albans (WV); On-site; USD 21,000 - 30,000; Part time

Job summary

THOM Thomas Hospitals seeks an Insurance Authorization Specialist to ensure pre-certification, verify coverage, and secure authorizations for procedures. You will contact carriers, calculate deductibles and co-pays, and document notes for front-end collection.

You will use the EPIC system for scheduling, billing edits, and care transition. You will follow up on eligibility issues, assist patients with financial counseling, and support denial management to resolve claims efficiently.

Qualifications

• High school diploma or equivalent.
• State criminal background check and Federal (if applicable).

Responsibilities

• Identifies all patients requiring pre-certification or pre-authorization when services are requested.
• Contacts insurance company to determine eligibility and benefits.
• Follows up with patient and insurer to resolve coverage issues.
• Uses EPIC for scheduling, transition of care, and billing edits.
• Documents referrals/authorization numbers and assists with denial management as needed.

Skills

Excellent communication

Written communication

Medical terminology

ICD-10 CPT coding

Third party payors knowledge

Business math

Time of service collection

Customer service

Telephone etiquette

Typing speed

Reading comprehension

Education

High school diploma

Background check

Tools

EPIC system

Job description

THOM Thomas Hospitals seeks an Insurance Authorization Specialist to ensure pre-certification, verify coverage, and secure authorizations for procedures. You will contact carriers, calculate deductibles and co-pays, and document notes for front-end collection.

You will use the EPIC system for scheduling, billing edits, and care transition. You will follow up on eligibility issues, assist patients with financial counseling, and support denial management to resolve claims efficiently.