Pre-Authorization Verification Specialist

Jewish Family & Children's Service of Arizona; Mesa (AZ); On-site; USD 48,000 - 64,000; Full time

Job summary

Jewish Family & Children's Service of Arizona is seeking a detail-oriented professional to support patients and streamline access to healthcare services. You will work with patients, insurers, and internal teams to ensure accurate information and coordinated services.

Responsibilities include collecting insurance information, verifying eligibility, handling prior authorizations, submitting requests, and maintaining EMR records.

Qualifications

• Experience as an Eligibility Specialist or similar role.
• Ability to work with clinical staff, providers and payers.
• Strong customer service and documentation accuracy.
• Bilingual preferred.
• DPS Fingerprint Clearance required.

Responsibilities

• Obtain and update copies of patients' insurance cards and demographics.
• Determine and verify insurance eligibility, benefits, and coverage.
• Assess whether services require prior authorization and submit requests.
• Track approvals to ensure timely patient care.
• Communicate with insurance companies to resolve issues and denials.
• Maintain accurate patient insurance records in the EMR.

Skills

Customer service

HIPAA compliance

Payer guidelines

Bilingual ability

Attention to detail

Education

High School Diploma or GED

Job description

JFCS is seekinga detail-oriented professional tojoin our teamin a rolefocusedon supporting patientsand ensuring asmooth process foraccessing healthcareservices. This positioninvolves working closelywith patients, insuranceproviders, and internalteams to helpensure information isaccurate and servicesare appropriately coordinated.

• Obtains and updated copies of patients' insurance cards and demographic information.
• Determines and verifies patient insurance eligibility, benefits, and coverage for AHCCCS, Medicaid, Medicare and third-party insurance coverage.
• Engages with patients to determine if services requested need prior authorization.
• Submits authorization requests and tracks approvals to ensure timely patient care.
• Communicates with insurance companies to resolve authorization issues and claim denials.
• Maintains accurate patient insurance records in the electronic medical record (EMR) system.

Qualifications

• Previous experience as an Eligibility Specialist and demonstrated ability to manage multiple insurance plans including third-party insurance, AHCCCS, Medicaid and Medicare plans.
• Capacity to work with clinical staff, providers and follow payer guidelines and HIPAA regulations
• Ability to work in a fast-paced environment and provide excellent customer service and maintain documentation accuracy.
• Bilingual Strongly Preferred
• Must Receive/Maintain DPS Fingerprint Clearance
• High School Diploma or GED
• Must be able to perform the essential functions of the job including prolonged sitting and in certain positions driving, lifting 20lbs, walking, standing, and executing dexterity with a keyboard or smart pad.