Remote Authorization & Cost Estimate Specialist

The Christ Hospital Health Network; Cincinnati (OH); On-site; USD 42,000 - 62,000; Full time

Job summary

The Christ Hospital Health Network is seeking an Authorization & Cost Estimate Specialist for a remote role with quarterly onsite training. The position combines authorization activities with cost estimation, requiring strong clinical knowledge of services and timely communication with insurance providers.

Responsibilities include verifying coverage, determining patient liabilities, creating cost estimates, and guiding patients through financial options.

Qualifications

• Knowledge of EHR programs (e.g., Epic), medical terminology, and insurance plans and benefits.
• Proficient critical thinking, detail-oriented, and problem-solving skills.
• Excellent written and verbal communication and interpersonal skills.
• Exceptional time management, conflict resolution, and multitasking abilities.
• Works well in a team environment and able to work independently.
• Proficient in Microsoft Office applications.
• Professionalism, trustworthiness, honesty, and integrity.
• Customer service and/or call center experience preferred.

Responsibilities

• Verify eligibility and benefits, determine coverage, secure pre-authorizations, and determine patient liabilities before scheduled appointments and during/after care.
• Verify medical necessity per CMS standards and communicate coverage/eligibility to the patient.
• Coordinate benefits by determining primary, secondary, and tertiary liability when needed.
• Obtain pre-certifications and pre-authorizations from third-party payers per payer requirements.
• Alert physician offices to verification or pre-authorization issues.
• Explain insurance terms and analyze information to determine patient liabilities.
• Refer patients to financial counselors for payment plans or financial assistance; assist with basic counseling as needed.
• Document the cost estimate in the EHR for collection prior to or on the date of service.

Skills

Epic EHR

Medical terminology

Insurance benefits knowledge

Critical thinking

Attention to detail

Communication skills

Time management

Teamwork

Microsoft Office

Professional integrity

Customer service experience

Education

High School Diploma or GED

Associate or Bachelor’s degree in healthcare administration

Tools

Epic EHR

Job description

The Christ Hospital Health Network is seeking an Authorization & Cost Estimate Specialist for a remote role with quarterly onsite training. The position combines authorization activities with cost estimation, requiring strong clinical knowledge of services and timely communication with insurance providers.

Responsibilities include verifying coverage, determining patient liabilities, creating cost estimates, and guiding patients through financial options.