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PHH Peak Health Holdings1 day ago

Insurance Authorization Specialist II

Remote · United States

Type
Full Time
Level
Mid Level
Education
Associates Degree
Company size
Unknown

Job Summary

Insurance Authorization Specialist II responsible for obtaining pre-certification/pre-authorization for services, verifying patient eligibility with payors, and ensuring accurate coding of diagnoses, procedures, and facilities. Uses the EPIC system for authorization workflows, follows up on requests timely, reviews clinical documentation to answer questions, and assists with denial management and retro-authorizations as needed. Focuses on securing reimbursement, minimizing write-offs, and keeping surgical schedules optimized; requires knowledge of ICD-10/CPT coding, medical terminology, and payor policies, plus strong communication and organizational skills.

Required Qualifications

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

Desired Qualifications

  • High school graduate or equivalent with 2 years working experience in a medical environment
  • Associate’s degree and 1 year of experience in a medical environment
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PHH Peak Health Holdings

Insurance Authorization Specialist II

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