Insurance Verification and Authorization Specialist (56080)

HEALTH SOLUTIONS; Pueblo (CO); On-site; USD 25,000 - 29,000; Full time

Benefits offered by this job

Generous benefits package

Paid holidays

EAP and wellness program

401(k) with employer match

Job summary

Health Solutions, a premier wellness center in Southern Colorado, is seeking a full-time Insurance Verification and Authorization Specialist to join our Revenue Cycle department in Pueblo, CO. The role focuses on verifying insurance coverage, obtaining prior authorizations, and ensuring compliance before services are rendered.

Responsibilities include communicating with providers, insurance companies, and patients; maintaining accurate charts, and assisting with Medicaid/other benefits, while

Qualifications

• High school diploma or equivalent.
• At least 3 years of medical office experience.
• Practical knowledge of Medicaid and Medicare payer rules.
• Excellent interpersonal and customer service skills.
• Proficient in Windows-based programs and electronic health records.

Responsibilities

• Verify patient insurance eligibility and active coverage.
• Obtain prior authorizations as required by payers.
• Assist with Medicaid applications and community assistance forms.
• Provide financial counseling and discuss patient financial obligations.
• Record accurate information in the EHR to support billing.

Skills

Interpersonal skills

Customer service

Multi-tasking

Time management

Verbal & written communication

Windows proficiency & EHR

Education

High School Diploma or equivalent

Tools

NextGen

MyAvatar

Job description

Job Details: Job Location: Montebello - Pueblo, CO, Position Type: Full Time, Education Level: High School, Salary Range: $18.08 - $20.78Hourly, Travel Percentage: Up to 25%, Job Shift: Day

Health Solutions is a premier wellness center focused on whole person care. With over 400 employees in Southern Colorado, you would be joining a mighty team of support and administrative staff, clinicians, physicians, nurses, and others in our efforts to improve the health and wellbeing of our community.

We're hiring for a full-time Insurance Verification and Authorization Specialist to join our Revenue Cycle department.

What You'll Be Doing

You'll be responsible for verifying patient insurance coverage, obtaining prior authorizations, and ensuring all necessary approvals are in place before services are rendered. You'll work closely with providers, insurance companies, and patients to streamline the authorization process and support timely, accurate billing.

RESPONSIBILITIES:

As an Insurance Verification & Authorization Specialist, you would report to the Director of Revenue Cycle Management and would assist clients with their insurance options, coverage and directing them to alternative resources in the community that are available to assist them, and reporting functions.

• Verifying eligibility, ensuring all insurances are active and insurance information is correct for health benefits and updating the chart with correct copay information prior to scheduling clients.
• Requesting authorizations when required by payers.
• Assist clients with completing applications for Medicaid, other insurance benefits and/or outside assistance or other community services. Ensure all appropriate forms are completed timely and accurately.
• Assist clients with sliding fee scale application.
• Provide financial counseling services to clients prior to treatment or when referred by other departments. Discuss patient financial obligations, billing practices, assess financial hardship and establish payment arrangements.
• Ensure that all relevant client information is recorded in the electronic health record to support proper billing of client balances.
• Monitor overdue accounts and proactively collect outstanding balances.
• Review Self-Pay accounts for collection agency submission.
• Provide exemplary customer service demonstrating patience and understanding while carrying out the Company's payment policies.
• Maintain strict confidentiality of sensitive and protected information in accordance with HIPAA regulations.
• Document financial counseling process and outcome and forward applicable information to the appropriate personnel and departments.
• Other duties as assigned.
• Physical requirements include the following: Constantly operates a computer and other office productivity machinery, such as a calculator, copy machine, and computer printer. Occasionally lifts and carries items up to 15 pounds.

What You'll Like About Us

• Competitive pay $18.08-$20.78 Hourly (Dependent on experience, certification and shift)
• Generous benefits package. For most positions, includes paid holidays, generous PTO, EAP, tuition reimbursement, retirement, insurances, FSA, and a premier wellness program
• Insurance: Medical, Dental, and Vision, with low deductibles. Also, Wellness benefits program available.
• HS Funded: EAP, LifeLock, Direct Path, Life and AD&D, LTD
• Retirement 403(b) with employer match up to 6%
• Additional Insurance: FSA, Voluntary Life, Sun Live Voluntary benefits, and pet insurance
• Childcare
• Flexible work schedule
• Employee recognitions and celebrations
• Warm and friendly work environment in which staff respect and learn from one another

Qualifications:

What we're looking For - The Must-Haves

• High school diploma or equivalent required
• At least 3 years of relevant medical office experience and basic understanding of billing processes
• Practical knowledge of payer specific rules and regulations, including Medicaid and Medicare
• Excellent interpersonal and customer service skills
• Demonstrated experience to include counseling, analysis, collaborative teamwork, professional communications and interactions, advocacy, financial management, and customer service.
• Willingness to work collaboratively with multiple teams and tasks;
• Proficient in Windows-based computer programs and electronic charts, as well as basic office equipment
• Ability to multi-task and prioritize in a fast-paced setting
• Well-organized, self-motivated, and proficient time management
• Strong communication skills both verbally and in writing

What we'd Like to See in you - The Nice-to-Haves

• Experience working in NextGen and MyAvatar electronic health record systems
• CAAS Certification
• Spanish language skills

Health Solutions expects all staff to

• Adapt to change in the workplace and use change as an opportunity for innovation and creativity.
• Take ownership of problems, brainstorm problem resolutions, and use sound judgment in selecting solutions to problems, and demonstrate consistent follow through.
• Possess the job knowledge and skills to perform the fundamental job functions, and willingly assume greater responsibility over time regarding the scope of work.
• Inspire and model collaborative teamwork and Human Kindness; and
• Demonstrate accommodation, politeness, helpfulness, trust building, appropriate boundaries, and flexibility in customer service.

Closing Date: 02/28/2027 EOE, M/F