Pre-Auth & Benefits Specialist

Conifer Health Solutions, LLC.; Frisco (TX); On-site; USD 22,000 - 33,000; Full time

Benefits offered by this job

Medical, dental, vision

401k with match

Paid time off (min 12 days/yr)

Job summary

Conifer Health Solutions, LLC. is seeking a Patient Service Center (PSC) support specialist in Frisco, TX to help ensure departmental efficiencies in benefits verification, authorization gathering, and submission.

You will work with PSC leaders to support operational and quality excellence and use multiple electronic tools required by Conifer and its clients. The role emphasizes accuracy in benefit verification, timely authorizations, and escalation of clinical issues while maintaining strong

Qualifications

• High School Diploma or GED required.
• 2-4 years experience in medical facility, health insurance, or related area.
• Some college coursework is preferred.

Responsibilities

• Verify benefits and determine authorization requirements.
• Secure required authorizations for inpatient, outpatient and emergency services.
• Address complex issues requiring clinical input and/or escalation (e.g. Peer to peer and/or denials).
• Interact with clients and revenue cycle staff to facilitate the authorization process and follow up on pending requests.
• Participate in quality control audit processes to improve scorecard metrics and suggest workflow improvements.

Education

High School Diploma or GED

Job description

Conifer Health Solutions, LLC. is seeking a Patient Service Center (PSC) support specialist in Frisco, TX to help ensure departmental efficiencies in benefits verification, authorization gathering, and submission.

You will work with PSC leaders to support operational and quality excellence and use multiple electronic tools required by Conifer and its clients. The role emphasizes accuracy in benefit verification, timely authorizations, and escalation of clinical issues while maintaining strong