Pre-Authorization & Insurance Specialist

WVU Medicine; Morgantown (WV); On-site; USD 42,000 - 56,000; Full time

Job summary

WVUH West Virginia University Hospitals in Morgantown, WV is seeking an Insurance Specialist to ensure all services are pre-authorized, benefits verified, and appropriately billed. The role requires attention to payor requirements, accurate documentation in EPIC, and coordination with Financial Counseling to resolve self-pay balances.

The ideal candidate will have excellent communication skills, basic medical terminology knowledge, and experience with ICD-10/CPT coding.

Qualifications

• High school diploma or equivalent required.
• Experience with insurance authorization preferred.
• Familiarity with EPIC or similar medical record systems is a plus.

Responsibilities

• Identify patients needing pre-certification or pre-authorization at service time.
• Follow up on accounts using system flags and prepare payor communications.
• Verify eligibility and benefits with insurance carriers for requested services.
• Explain anticipated self-pay portions to patients and coordinate with Financial Counselors.
• Enter and verify referrals/authorization numbers in the EPIC system.
• Assist with denial management and communicate workflow issues to management.

Skills

Excellent communication

Written communication

Medical terminology

ICD-10 CPT coding

Time of service collection

Customer service

Typing speed (25 wpm)

Reading comprehension

Education

High school diploma or equivalent

Job description

WVUH West Virginia University Hospitals in Morgantown, WV is seeking an Insurance Specialist to ensure all services are pre-authorized, benefits verified, and appropriately billed. The role requires attention to payor requirements, accurate documentation in EPIC, and coordination with Financial Counseling to resolve self-pay balances.

The ideal candidate will have excellent communication skills, basic medical terminology knowledge, and experience with ICD-10/CPT coding.