Medical Insurance Verifications & Authorizations Specialist

Better Health; United States; On-site; USD 36,000 - 48,000; Part time

Job summary

Better Health in Birmingham, AL is seeking an experienced Insurance Verification & Authorization Specialist to support revenue cycle and patient intake. The role focuses on verifying benefits, determining authorization requirements, obtaining prior authorizations, and processing PCP referrals to ensure services are provided smoothly.

The ideal candidate has hands-on medical field experience, strong attention to detail, and excellent communication skills to coordinate with insurance companies,

Qualifications

• Hands-on experience in the medical field is required.
• Experience with medical insurance eligibility and benefits verification.
• Experience checking and obtaining prior authorizations.
• Experience submitting PCP referrals and following up with provider offices.
• Strong written and verbal communication skills.
• Ability to manage multiple requests with minimal supervision.
• Proficiency with computers, spreadsheets, and electronic documentation systems.
• HIPAA compliance and protecting patient information.

Responsibilities

• Verify patients' insurance eligibility and active coverage.
• Review benefits like deductibles, copayments, coinsurance, and out-of-pocket costs.
• Confirm in-network vs out-of-network benefits and provider participation.
• Identify coverage limitations and payer-specific requirements.
• Determine if prior authorizations or PCP referrals are needed.
• Document verification results accurately in systems.
• Communicate insurance findings and financial responsibilities to internal teams.
• Review authorization requirements for medical services, supplies or DME.
• Submit authorization requests with required documentation.
• Follow up on pending authorizations with insurers and UM departments.
• Track status, dates, and expiry of authorizations.
• Identify missing documentation and escalate delays or denials.
• Maintain records of submissions and responses.
• Communicate updates to internal departments.
• Verify whether PCP referrals are required and obtain referrals.
• Submit referrals and follow up with providers and insurers.
• Track referral status and expiration dates where applicable.
• Ensure referrals are documented before services or orders.

Skills

Medical background

Insurance verification

Prior authorizations

PCP referrals

Communication

HIPAA compliance

Job description

Better Health in Birmingham, AL is seeking an experienced Insurance Verification & Authorization Specialist to support revenue cycle and patient intake. The role focuses on verifying benefits, determining authorization requirements, obtaining prior authorizations, and processing PCP referrals to ensure services are provided smoothly.

The ideal candidate has hands-on medical field experience, strong attention to detail, and excellent communication skills to coordinate with insurance companies,