Job Description

• Verify insurance benefits and determine authorization requirements prior to patient visits
• Submit track and follow up on all prior authorization requests across multiple payers
• Proactively resolve pending or denied authorizations to prevent delays in care
• Communicate authorization status clearly with front office teams and clinicians
• Maintain accurate up-to-date documentation in the EMR 
• Monitor schedules to ensure all visits are authorized in advance when required
• Work directly with insurance companies via phone and payer portals (e.g. Availity)
• Collaborate cross-functionally to support patient access and clinic performance
• Identify trends in denials or delays and escalate opportunities for improvement
• Ensure compliance with payer guidelines and company policies

Qualifications :

• 12 years of experience in insurance verification prior authorizations or medical office operations
• Strong understanding of insurance plans (commercial Medicare Medicaid)
• Experience managing prior authorizations from submission through approval
• Familiarity with EMR systems and healthcare workflows
• High attention to detail and accuracy
• Strong organizational and time management skills
• Clear professional communication skills
• Problem-solving mindset with the ability to navigate denials and delays
• High level of accountability and follow-through

Additional Information :

Benefits:

• Comprehensive medical insurance plans - HSA and PPO Options
• Dental and vision insurance
• Paid holidays & time off
• 401K
• Integrated mentorship program
• Customized EMR
• Hybrid work schedule

Remote Work :

No

Employment Type :

Full-time

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