Prior Authorization Specialist

Infusion For Health is dedicated to serving patients with autoimmune disorders and complex chronic conditions through exceptional infusion therapy. Our mission is to provide a patient-focused environment that emphasizes professional care, compassion, and collaboration to ensure optimal treatment outcomes.

Job Description

• Prepare and submit detailed authorization requests to insurance companies
• Assist in coordinating prior authorizations when required for certain procedures or services
• Keep track of authorization requests, follow up with insurance companies, and keep detailed records of all communications related to insurance claims.
• Investigate insurance denials, resubmit requests, and appeals when required
• Contact insurance companies to verify patient insurance information, coverage, and benefits.
• Ensure insurance information is entered correctly into the system and updated regularly.
• Liaise with insurance companies, medical staff, and patients to resolve any discrepancies or issues with coverage.
• Document and report any issues with insurance eligibility or benefit discrepancies to the appropriate departments for further action.
• Communicate with patients to request any missing or updated insurance information.

Qualifications:

• High school diploma or equivalent; some college or healthcare-related certification preferred.
• Previous experience in insurance verification, medical billing experience
• Knowledge of healthcare insurance plans, benefits, and claims processes.
• Strong attention to detail and organizational skills.
• Excellent communication skills, both written and verbal.
• Proficiency with insurance verification software and electronic health record (EHR) systems.