Insurance Verification & Authorization Specialist

Sioux Center Health; Sioux Falls (SD); On-site; USD 28,000 - 36,000; Full time

Benefits offered by this job

PTO day 1 for eligible hires

Employer matching retirement plan (up 

Career development and mentorship

Job summary

Avera Downtown Building in Sioux Falls seeks an Insurance Specialist to verify eligibility, determine benefits, and manage authorization processes to prevent denials while optimizing reimbursement. The role requires strong knowledge of insurance plans, patient liability interpretation, and collaboration with multiple departments.

The successful candidate will calculate patient estimates, assist with charity applications, and guide patients through payment options, ensuring compliance with HIPAA

Qualifications

• Must be able to communicate effectively with others and handle sensitive information.
• Ability to verify insurance information and explain financial responsibility to patients.
• Experience in billing, insurance or registration is preferred.

Responsibilities

• Process eligibility and verify benefits with insurance companies and employers.
• Identify payment sources and required authorizations to prevent denials.
• Obtain referrals and pre-certifications from physicians as required by payers.
• Enter all necessary patient demographic and insurance information into the health system.
• Calculate patient estimates using a deposit matrix and communicate financial expectations.
• Educate patients on benefits and payment options and refer to the business office as needed.

Skills

Communication

Attention to detail

Teamwork

Education

Associate's finance, business or healthcare

Job description

Avera Downtown Building in Sioux Falls seeks an Insurance Specialist to verify eligibility, determine benefits, and manage authorization processes to prevent denials while optimizing reimbursement. The role requires strong knowledge of insurance plans, patient liability interpretation, and collaboration with multiple departments.

The successful candidate will calculate patient estimates, assist with charity applications, and guide patients through payment options, ensuring compliance with HIPAA