Insurance Authorization Specialist — Claims & Eligibility

Talentify; Conway (SC); On-site; USD 42,000 - 50,000; Full time

Job summary

Conway Medical Center is seeking an Authorization Specialist to assign patients for insurance review to determine if an authorization is required for orders. The role focuses on verifying demographics and up-to-date insurance information to ensure accurate reimbursement submission.

The specialist collaborates with clinical staff, educates patients on coverage and payment options, and strives to minimize payer denials by adhering to policies and procedures in a fast-paced environment at the

Qualifications

• Two years’ experience in hospital/physician billing or insurance verification.
• Knowledge of Medicare, Medicaid, HMOs and PPOs required.
• Familiarity with EHRs and documentation requirements.
• Knowledge of online insurance eligibility and verification systems.

Responsibilities

• Collaborates with clinical contacts requiring escalation to peer-to-peer review.
• Facilitates clean claims submission and reduces payer denials per policies.
• Educate and counsel patients on insurance coverage and payment options.
• Work with front line staff to secure collections at time of presentation.
• Displays exemplary customer service and effective verbal/written communication.
• Proficient with technology/PC skills; maintain accuracy and productivity.
• Complete other duties as assigned by department leadership.

Skills

Insurance verification

Medical terminology

Customer service

Communication

Education

High School Diploma

Tools

EHR systems

Insurance portals

Job description

Conway Medical Center is seeking an Authorization Specialist to assign patients for insurance review to determine if an authorization is required for orders. The role focuses on verifying demographics and up-to-date insurance information to ensure accurate reimbursement submission.

The specialist collaborates with clinical staff, educates patients on coverage and payment options, and strives to minimize payer denials by adhering to policies and procedures in a fast-paced environment at the