Prior Authorization Specialist Insurance Verification Coordinator

Prosperity Placement Solutions; Columbia (SC); On-site; USD 46,000 - 60,000; Full time

Benefits offered by this job

Medical, Dental, and Vision Insurance

401(k) Retirement Plan

Paid Time Off (PTO)

Tuition Assistance

Job summary

Prosperity Placement Solutions in Columbia, South Carolina is hiring an Insurance Case Manager / Prior Authorization Specialist. This full-time position is crucial for ensuring patients access necessary infusion therapies by verifying health benefits and managing authorization processes.

Required qualifications include a High School Diploma and at least 1 year of experience in health insurance verifications. The role offers comprehensive benefits, including medical, dental, vision, and 401(k) plans.

Qualifications

• 1+ years of experience in health insurance verifications and prior authorizations.
• Experience with specialty medication or infusion is a plus.
• Ability to stay organized in a fast-paced environment.

Responsibilities

• Verify comprehensive insurance benefits using web portals and phone outreach.
• Secure authorizations based on medical necessity guidelines.
• Collaborate with various teams to ensure smooth patient onboarding.

Skills

Health insurance benefit verifications

Prior authorizations

MS Office proficiency

Teamwork skills

Education

High School Diploma or Equivalent

Job description

Prior Authorization Specialist / Insurance Verification Coordinator

Job Details

• Pay: $23.00 - $26.00 an hour
• Job Type: Full-time
• Schedule: Monday to Friday, 8:00 AM – 5:00 PM (No weekends)
• Benefits: Medical, Dental, Vision, 401(k), PTO, Tuition Assistance (Full Benefits Package)

About Us

We provide comprehensive ambulatory and home‑based infusion services to both acute and chronically ill patients. Our centers care for people by providing patients and their families with a convenient, affordable, and safe place to receive infusion treatments.

We believe in creating a healthcare experience that goes beyond just a job. We are a connected group of caretakers who work together to restore health and hope to our patients. For our employees, this means a culture of belonging, mutual respect, empathy, and continuous collaboration.

Role Overview (As a Patient Access Navigator)

We are seeking an Insurance Case Manager / Prior Authorization Specialist to function as a vital bridge between our clinical team, intake coordinators, and insurance payers. In this role, you aren't just processing paperwork—you are a Patient Access Navigator, ensuring patients get timely access to life‑changing infusion therapies by accurately verifying health benefits and securing critical authorizations.

Essential Functions

• Verify Benefits: Utilize web portals and phone outreach to verify comprehensive insurance benefits.
• Secure Authorizations: Review payer medical policies to determine medical necessity based on guidelines and FDA indications; manage the prior authorization and reauthorization process.
• Ensure Data Integrity: Obtain and review patient data, signed written orders (SWO), and letters of medical necessity (LMN) from referring physician offices.
• Collaborate: Partner closely with Intake Coordinators, Nurse Managers, and the Reimbursement team to ensure smooth patient onboarding and high operational standards.
• Communicate & Document: Complete insurance verification forms, scan documents into electronic medical records, and provide clear coverage summaries to the team.
• Financial Coordination: Coordinate first payments and payment plans for patients when necessary.
• Support: Participate in an on‑call rotation for after‑hours and holidays as needed.

Qualifications & Skills

• Education: High School Diploma or Equivalent (Required).
• Experience: 1+ years of experience managing health insurance benefit verifications and prior authorizations (Required). Specialty medication or infusion experience is a plus.
• Software: Proficiency in MS Office (Outlook, Word, Excel) and electronic medical records.
• Attributes: Ability to stay calm, organized, and focused in an ambiguous, fast‑paced environment. Strong teamwork and relationship‑building skills.

Full Benefits Package

• Comprehensive Medical, Dental, and Vision Insurance
• Company‑Paid Life Insurance + Voluntary Life & Disability
• Flexible Spending Accounts (FSA) & Health Savings Account (HSA)
• 401(k) Retirement Plan
• Paid Time Off (PTO) + 8 Paid Company Holidays
• Tuition Assistance & Employee Referral Program
• Employee Assistance Program (EAP) & Employee Discounts
• Ramsey SmartDollar Financial Wellness Program

Physical Demands

• Prolonged periods of sitting, reading, and keyboarding/computer vision.
• Frequent standing, walking, bending, twisting, talking, and hearing.
• Occasionally lifting and/or moving up to 25 pounds.