Prior Auth & Insurance Verification Expert

Ohio Gastroenterology Group, Inc.; Columbus (OH); On-site; USD 36,000 - 54,000; Full time

Job summary

Ohio Gastroenterology Group, Inc. is seeking an Insurance Verification and Prior Auth Specialist to verify patient coverage, obtain pre-authorizations, and coordinate with billing and scheduling to ensure timely approvals.

The role requires knowledge of Medicare, Medicaid, and third-party payer rules, with experience in revenue cycle tasks and eClinicalWorks preferred. The applicant should have a high school diploma or equivalent and strong communication skills to assist patients and internal

Qualifications

• Knowledge of Medicare, Medicaid and third-party payer requirements
• Experience with revenue cycle functions including eligibility and prior authorization preferred
• Understanding medical terminology and procedures
• Proficient in Microsoft Office and payer portals

Responsibilities

• Verify insurance benefits and eligibility prior to service
• Obtain and document preauthorizations and certifications
• Coordinate with scheduling, physicians and billing to ensure timely approvals
• Enter and maintain accurate insurance data in the billing system
• Respond to patient inquiries about coverage and out-of-pocket costs
• Assist staff with changes to insurance verification and pre-certification processes

Skills

Insurance verification

Prior authorization

Medicare/Medicaid knowledge

Communication skills

Education

High school diploma or equivalent

Tools

eClinicalWorks

Job description

Ohio Gastroenterology Group, Inc. is seeking an Insurance Verification and Prior Auth Specialist to verify patient coverage, obtain pre-authorizations, and coordinate with billing and scheduling to ensure timely approvals.

The role requires knowledge of Medicare, Medicaid, and third-party payer rules, with experience in revenue cycle tasks and eClinicalWorks preferred. The applicant should have a high school diploma or equivalent and strong communication skills to assist patients and internal