Pre-Auth & Denials Specialist — Healthcare Revenue

EngageMED, Inc.; North Little Rock (AR); On-site; USD 44,000 - 64,000; Full time

Job summary

EngageMED, Inc. is seeking a Prior Authorization Specialist to verify insurance, obtain precertifications, and handle authorization requirements before procedures.

The role involves reviewing patient data, communicating benefits, and supporting revenue functions across inpatient, outpatient, and ED settings. You will work with diverse teams to ensure timely approvals, accurate documentation, and minimal delays, while demonstrating EngageMED values and professional communication with patients and

Qualifications

• Experience in hospital or medical office billing, pre-certification and authorization.
• Knowledge of insurance guidelines and third-party payors.
• Proficient with ICD-10 and CPT codes.

Responsibilities

• Review demographic, billing and insurance information for accuracy.
• Verify insurance eligibility and make necessary corrections.
• Obtain precertification and prior authorization.
• Communicate detailed policy benefits to patients.
• Respond to calls and correspondence relating to patient accounts.
• Navigate insurer websites to obtain required approvals and avoid delays.
• Provide timely referral/pre-notification/authorization services.

Skills

Communication

Teamwork Orientation

Service Orientation

Achieves Results

Tools

Microsoft Office

Job description

EngageMED, Inc. is seeking a Prior Authorization Specialist to verify insurance, obtain precertifications, and handle authorization requirements before procedures.

The role involves reviewing patient data, communicating benefits, and supporting revenue functions across inpatient, outpatient, and ED settings. You will work with diverse teams to ensure timely approvals, accurate documentation, and minimal delays, while demonstrating EngageMED values and professional communication with patients and