Insurance & Medical Authorization Specialist

Yale New Haven Health; Oregon; Hybrid; USD 52,000 - 78,000; Full time

Job summary

Yale New Haven Health is seeking a Financial Clearance Analyst to verify insurance benefits, assess medical necessity, and coordinate patient accounts from scheduling through clearance. The role requires strong knowledge of payer rules, CMS guidelines, and Epic applications.

You will input accurate insurance data, obtain pre-authorizations, and communicate coverage details to patients and care teams. Experience in health care revenue cycle and Excel proficiency are preferred.

Qualifications

• Must have high school diploma or GED; associate degree preferred.
• CRCS or equivalent certification for Access Professionals required or in process (within 18 months).
• Experience with insurance authorization/verification, revenue cycle, and hospital/physician offices preferred.

Responsibilities

• Handle financial clearance of complex patient authorizations, including insurance verification and price estimation.
• Coordinate patient account activities from scheduling to clearance.
• Identify and resolve non-clinical issues impacting payment and authorization timing.
• Communicate care and coverage details to patients, clinicians, and payers; ensure compliance with payer guidelines.

Skills

Organizational skills

Interpersonal skills

Payer reimbursement processes

Insurance terminology

Verbal and written communication

Medical terminology knowledge

Microsoft Office (Excel/Word)

Education

High school diploma or GED

Associate degree (preferred)

CRCS or equivalent Access Professionals certification

Tools

Epic

Outlook

On-line Eligibility system

Excel

Word

Job description

Yale New Haven Health is seeking a Financial Clearance Analyst to verify insurance benefits, assess medical necessity, and coordinate patient accounts from scheduling through clearance. The role requires strong knowledge of payer rules, CMS guidelines, and Epic applications.

You will input accurate insurance data, obtain pre-authorizations, and communicate coverage details to patients and care teams. Experience in health care revenue cycle and Excel proficiency are preferred.