Insurance Authorization & Financial Counseling Specialist

WVU Medicine; Wheeling (WV); On-site; USD 42,000 - 64,000; Full time

Job summary

WVU Medicine in Wheeling, WV seeks an Insurance Authorization Specialist to ensure all services are pre-approved and authorized. The role involves verifying coverage, scheduling, and managing payor communications to minimize reimbursement errors.

The candidate should have a high school diploma or equivalent, comfort with EPIC, and strong communication skills. Prior insurance authorization experience is preferred. This is a full-time position in a standard office setting.

Qualifications

• Must have high school diploma or equivalent.
• Background checks required (state and federal as applicable).
• Preferred: prior insurance authorization experience.

Responsibilities

• Identifies patients requiring pre-certification or pre-authorization.
• Contacts insurance company or employer to determine eligibility and benefits.
• Performs medical necessity screening as required by third party payors.
• Documents referrals/authorization numbers in the EPIC system.
• Initiates charge anticipation calculations and identifies anticipated self-pay portions.
• Communicates anticipated self-pay amounts to patients and routes remaining to Financial Counselors.

Skills

Communication skills

Typing speed 25 wpm

Customer service

Reading comprehension

Medical terminology

ICD-10/CPT coding knowledge

Education

High school diploma or equivalent

Tools

EPIC system

Job description

WVU Medicine in Wheeling, WV seeks an Insurance Authorization Specialist to ensure all services are pre-approved and authorized. The role involves verifying coverage, scheduling, and managing payor communications to minimize reimbursement errors.

The candidate should have a high school diploma or equivalent, comfort with EPIC, and strong communication skills. Prior insurance authorization experience is preferred. This is a full-time position in a standard office setting.