Pre-Authorization Specialist
On-siteAustin, Texas, United States
Job Summary
Verify insurance eligibility, benefit levels, and pre-certification requirements for outpatient and ancillary services before service delivery. Communicate with payers via electronic, telephonic, and fax channels to obtain authorizations and investigate predetermination needs, ensuring all notifications occur within 24 business hours. Collaborate with clinical partners on escalations and document accurate information in the electronic medical record while prioritizing urgent cases. Answer questions from providers, staff, and patients regarding authorization requirements and adhere to departmental policies to reduce claim denials. Requires a high school diploma, three years of insurance verification experience, and regular attendance from 8:00 to 5:00 M-F in a medical office environment.
Required Qualifications
- Must be local to Austin/ the surrounding area
- Requires a high school diploma or GED
- Minimum of three years' experience in billing/pre-authorization or insurance verification
- demonstrated knowledge of health insurance plans including: Medicare, Medicaid, HMO's and PPO's required
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