Insurance Authorization Specialist

Insurance Authorization Specialist verifies that scheduled procedures are covered by the patient’s insurance or that the patient meets self-pay requirements. They confirm insurance eligibility, benefits, authorizations, and that procedures are approved for the ASC. They calculate estimated patient financial responsibility, document verification details in the patient accounting system, and complete a Pre-Registration Financial Orientation call to review expected costs before the date of service. Responsibilities include verifying insurance before service, contacting physician offices/patients for information, entering payer details into the billing system, using eligibility vendors, obtaining authorizations, communicating estimated financial responsibility to patients, ensuring CMS and compliance practices, and maintaining confidential patient information per HIPAA guidelines. Qualifications include an associate degree or equivalent, medical office experience, proficiency with Excel/Word, and strong communication skills.