Insurance Verification & Authorization Specialist

Phelps Health; Rolla (MO); On-site; USD 38,000 - 52,000; Full time

Job summary

Phelps Health in Rolla, MO is seeking an Insurance Verification/Prior Authorization Team Member to verify patient eligibility, determine benefits, and obtain pre-authorization before exams.

You will handle authorizations for surgical, lab, and imaging, contact payers, and verify plan benefits. The role requires at least 1 year in healthcare and familiarity with CPT and ICD-10 codes.

A high school diploma is required; RMA or LPN preferred.

Qualifications

• High school diploma or equivalent is required.
• Graduate of a Registered Medical Assistant or Licensed Practice Nurse program preferred.
• Minimum 1 year of clinical experience in a health care organization.
• Experience in insurance verification and prior authorization preferred; knowledge of CPT & ICD-10 codes preferred.

Responsibilities

• Obtains or assists in obtaining prior authorization/precertification from insurance payers for procedures.
• Processes multiple prior authorization requests efficiently and documents decisions.
• Makes and receives calls on status of authorizations and verifies benefits.
• Confirms member eligibility and benefits prior to pre-certification; uses clinical resources as needed.

Skills

Medical terminology

CPT & ICD-10 codes

Insurance verification

Prior authorization

Education

High school diploma or equivalent

Registered Medical Assistant (RMA)

Licensed Practice Nurse (LPN)

Job description

Phelps Health in Rolla, MO is seeking an Insurance Verification/Prior Authorization Team Member to verify patient eligibility, determine benefits, and obtain pre-authorization before exams.

You will handle authorizations for surgical, lab, and imaging, contact payers, and verify plan benefits. The role requires at least 1 year in healthcare and familiarity with CPT and ICD-10 codes.

A high school diploma is required; RMA or LPN preferred.