Remote Insurance Authorization Specialist III

WVU Medicine; United States; On-site; USD 55,000 - 75,000; Full time

Job summary

SYSTEM West Virginia University Health System is seeking an Insurance Authorization Specialist III to obtain prior authorizations for infusions and injections, ensuring timely authorization and reimbursement. You will work within the EPIC system and coordinate with clinical teams to resolve questions and maximize efficiency.

Candidates should have 2 years in a medical setting or an Associate’s degree with 1 year of medical experience, strong communication, and proficiency with CPT/ICD-10 coding

Qualifications

• High school diploma or equivalent with 2 years experience in a medical environment.
• Associate’s degree with 1 year of experience in a medical environment.

Responsibilities

• Utilize EPIC work queues to manage workloads and meet deadlines.
• Submit and follow up on outpatient authorizations.
• Review medical records to answer clinical questions during authorization.
• Verify authorization requirements via insurance portals or by calling payors.
• Communicate clearly with clinics when additional information is needed.
• Maintain confidentiality and comply with hospital standards.

Skills

Medical terminology

ICD-10

CPT codes

Microsoft Office

Communication

Time management

Prior authorization processes

Education

High school diploma or equivalent

Associate’s degree

Tools

EPIC

Outlook

Job description

SYSTEM West Virginia University Health System is seeking an Insurance Authorization Specialist III to obtain prior authorizations for infusions and injections, ensuring timely authorization and reimbursement. You will work within the EPIC system and coordinate with clinical teams to resolve questions and maximize efficiency.

Candidates should have 2 years in a medical setting or an Associate’s degree with 1 year of medical experience, strong communication, and proficiency with CPT/ICD-10 coding