Remote Insurance Authorization Specialist

aah; Winston-Salem (NC); Remote; USD 48,000 - 71,000; Full time

Benefits offered by this job

Health and welfare benefits

Paid Time Off

Flexible Spending Accounts

Educational Assistance Program

Retirement plans with employer match

Job summary

Advocate Health seeks a remote Pre-Arrival Authorization Specialist to manage payer requirements and complete insurance authorizations for inpatient and outpatient services. You will gather clinical data, assign procedure codes, and support reimbursement decisions.

Responsibilities include coordinating with patients and departments on uninsured/out-of-network cases, verifying eligibility, and ensuring accurate ADT entries with proper carrier codes and benefits data.

Qualifications

• 2 years of experience in health care, insurance, call center, or customer service.
• Ability to solve problems in a high profile, high stress environment.
• Strong communication and organizational skills.

Responsibilities

• Acquires and maintains knowledge of payor requirements for authorization and hospital billing.
• Performs insurance authorization for inpatient and outpatient services with accurate data.
• Notifies patients of financial responsibility when authorization is not obtained.
• Ensures accurate patient registration data and HIPAA compliance.
• Engages in department meetings and continuing education to maintain competency.

Skills

Problem solving

Prioritization

Communication

Medical terminology

Anatomy knowledge

General computer knowledge

Education

High School Graduate

Job description

Advocate Health seeks a remote Pre-Arrival Authorization Specialist to manage payer requirements and complete insurance authorizations for inpatient and outpatient services. You will gather clinical data, assign procedure codes, and support reimbursement decisions.

Responsibilities include coordinating with patients and departments on uninsured/out-of-network cases, verifying eligibility, and ensuring accurate ADT entries with proper carrier codes and benefits data.