Insurance Verification & Authorization Specialist

Shriners Children's; Salt Lake City (UT); On-site; USD 36,000 - 52,000; Full time

Job summary

Shriners Children’s Salt Lake City is seeking a full-time Insurance Verification Specialist to coordinate authorization approvals and denials for services. You will verify benefits, communicate pre-authorizations, and work with patients and providers to resolve coverage issues.

Ideal candidates have knowledge of health care insurance systems, medical terminology, and proficiency with Microsoft Office; HS diploma or GED is preferred. You’ll join a collaborative, mission-driven pediatric care team.

Qualifications

• Knowledge of health care insurance systems, plans, and third-party payer requirements.
• Medical terminology sufficient to discuss appointments, services, and authorizations.
• Proficiency with Word, Excel, Outlook and related Office tools.
• Understanding of insurance eligibility and benefit verification.

Responsibilities

• Maintains understanding of major insurance plans and medical terminology.
• Obtains and communicates pre-authorization per company requirements.
• Obtains complete insurance information and verifies benefits; flags coverage issues.
• Checks insurance eligibility and updates electronic records.
• Responds to inquiries from patients, providers and staff.
• NotifiesFinance of gaps in coverage or high co-pays before services.
• Greet patients, complete paperwork, enter data into EMR, verify eligibility.
• Explain benefits and financial responsibility to parent/guardian.
• Maintains tracking for follow-up on authorization requests.

Skills

Insurance verification

Pre-authorization

Medical terminology

Microsoft Office

Education

High School Diploma/GED

Tools

Microsoft Word

Excel

Outlook

Job description

Shriners Children’s Salt Lake City is seeking a full-time Insurance Verification Specialist to coordinate authorization approvals and denials for services. You will verify benefits, communicate pre-authorizations, and work with patients and providers to resolve coverage issues.

Ideal candidates have knowledge of health care insurance systems, medical terminology, and proficiency with Microsoft Office; HS diploma or GED is preferred. You’ll join a collaborative, mission-driven pediatric care team.