Pre-Authorization Specialist

6 days ago


WI United States LanceSoft Full time
Job Title: Pre-Authorization Specialist

LanceSoft is seeking a highly skilled Pre-Authorization Specialist to join our team. As a key member of our Pre-Authorization Department, you will be responsible for verifying patient eligibility, obtaining insurance benefits, and ensuring pre-certification authorization and referral requirements are met prior to the delivery of inpatient, outpatient, and ancillary services.

Key Responsibilities:
  • Verify patient eligibility and obtain insurance benefits to ensure adequate coverage for identified services.
  • Work with payers via electronic, telephonic, and/or fax communications to obtain necessary authorizations.
  • Collaborate with clinical contacts to resolve encounters that require escalation to peer-to-peer review.
  • Facilitate submission of clean claims and reduce payer denials by adhering to organizational and departmental policies and procedures.
  • Ensure timely and accurate insurance authorizations are in place prior to services being rendered.
Requirements:
  • Minimum of two years experience in hospital billing/pre-authorization or insurance verification with demonstrated knowledge of health insurance plans, including Medicare, Medicaid, HMOs, and PPOs.
  • Prior experience in a business office position with strong customer service background and exceptional customer relations skills.
  • Familiarity with Medical Terminology and online insurance eligibility systems.
What We Offer:
  • A dynamic and supportive work environment.
  • Opportunities for professional growth and development.
  • A competitive salary and benefits package.


  • , WI, United States Javen Technologies Full time

    Job Title: Pre-Authorization SpecialistThe Pre-Authorization Specialist plays a crucial role in the Pre-Authorization Department, responsible for verifying patient eligibility, obtaining insurance benefits, and ensuring pre-certification authorization and referral requirements are met prior to delivering inpatient, outpatient, and ancillary services. This...


  • , GA, United States Ortho Sport and Spine Physicians Full time

    Job OverviewOrtho Sport and Spine Physicians is seeking a detail-oriented Pre-Authorization Specialist to manage insurance pre-authorizations for various services, ensuring timely care for patients.Key ResponsibilitiesSubmit and track authorization requests with insurance companies for procedures such as MRI, spine interventions, surgeries, and durable...


  • , WI, United States Neuroscience Group Full time

    Job Title: Prior Authorization SpecialistWe are seeking a highly skilled Prior Authorization Specialist to join our Clinical Services Team at Neuroscience Group of Northeast Wisconsin S.C.Key Responsibilities:Collect and verify patient insurance information to ensure accurate pre-authorizationReview clinical documentation to determine medical necessity for...


  • , NH, United States MaineHealth Full time

    Job SummaryWe are seeking a skilled Authorization Specialist to join our team at MaineHealth · Primary Care. As a key member of our clinical team, you will play a critical role in ensuring seamless patient care by facilitating pre-authorization requests for surgical procedures, radiology, durable medical equipment, and prescriptions.Key...


  • , FL, United States Florida Digestive Health Specialists LLP Full time

    Job Title: Authorization SpecialistWe are seeking a detail-oriented and organized Authorization Specialist to join our team at Florida Digestive Health Specialists LLP.Job SummaryThe Authorization Specialist will be responsible for efficiently coordinating all aspects of patient procedures within our gastroenterology office. This role requires excellent...


  • , TX, United States Prelude Fertility Full time

    Authorization Specialist Job DescriptionPrelude Fertility is seeking a highly skilled Authorization Specialist to join our team. As an Authorization Specialist, you will play a critical role in ensuring that our patients receive the necessary authorizations for their medical treatments.Key Responsibilities:Eligibility Verification: Verify patient eligibility...


  • , TX, United States Sports Medicine Associates of San Antonio Full time

    Job SummaryWe are seeking a highly skilled Authorization Specialist to join our team at Sports Medicine Associates of San Antonio. As an Authorization Specialist, you will play a critical role in ensuring seamless patient care by managing prior authorizations, verifying insurance benefits, and communicating with payers.Key ResponsibilitiesInterpret and...


  • , TN, United States Traditions Health Full time

    Job Title: Authorization SpecialistThe Authorization Specialist plays a crucial role in ensuring the smooth operation of our medical office. This position is responsible for obtaining prior authorizations for all procedural orders by successfully completing the authorization process with all commercial, insurance-managed Medicare Advantage plans and other...


  • , CA, United States TEKsystems Full time

    Authorization Coordinator Job DescriptionThe Authorization Coordinator position is responsible for ensuring seamless patient care by verifying patient eligibility, coordinating benefits, and determining insurance coverage. This role requires strong communication and organizational skills to facilitate responses to patient and provider inquiries regarding...


  • , CO, United States United Musculoskeletal Partners Full time

    Job SummaryWe are seeking a highly skilled Authorization Specialist to join our team at Summit Orthopedics. As a key member of our team, you will be responsible for ensuring that insurance benefits are verified, patient responsibility amounts are calculated, and authorizations are obtained on all tests, injections, and surgical procedures prior to the...


  • San Antonio, TX, United States TSAOG Orthopaedics & Spine Full time

    Get to know us:TSAOG Orthopaedics and Spine is a large multi-specialty physician group. We have been here since 1947 and were not going anywhere. We take a big part in Community outreach with our Light Charity program. If you are looking for a team that enjoys Laughing, is Family orientated, and has the work hard play hard mentality, then this company is for...


  • , OH, United States Southwest General Full time

    Prior Authorization Representative Role Summary:The Prior Authorization Representative at Southwest General reviews patient accounts to determine the need for authorization for services. They collaborate with insurance companies and physician offices to obtain authorization for outpatient services at the Health Center.Key Responsibilities:Review patient...


  • Centennial, CO, United States Veros Health Full time

    *Benefits*Pulled from the full job description* 401(k)* 401(k) matching* Dental insurance* Disability insurance* Employee assistance program* Flexible spending account* Health insurance*Full job description*Veros Clinical Services, Infusion and Biologics Center has an exciting opportunity for an experienced Authorization Specialist in Centennial.Salary...


  • Sarasota, FL, United States Florida Digestive Health Specialists LLP Full time

    Description: The Insurance Authorization Specialist is responsible for ensuring timely and accurate authorization of medical procedures, treatments, and services. This role involves close coordination with healthcare providers, insurance companies, our Central Billing Office (CBO), and patients to verify coverage and secure the necessary approvals to...


  • Garden City, NY, United States Orlin & Cohen Medical Specialist Group Full time

    Orlin & Cohen is one of the largest orthopedics practices in the region, with 20 offices in Nassau and Suffolk Counties, Queens, and Staten Island. We have been in business for more than 25 years and have over 1200 dedicated healthcare employees in our care. Team members enjoy competitive salaries, exceptional medical benefits, and generous PTO.We are...


  • Garden City, NY, United States Orlin & Cohen Medical Specialist Group Full time

    Orlin & Cohen is one of the largest orthopedics practices in the region, with 20 offices in Nassau and Suffolk Counties, Queens, and Staten Island. We have been in business for more than 25 years and have over 1200 dedicated healthcare employees in our care. Team members enjoy competitive salaries, exceptional medical benefits, and generous PTO.We are...


  • Colorado Springs, CO, United States VirtualVocations Full time

    A company is looking for an Authorization Specialist III to support the prior authorization request process in the utilization management team. Key Responsibilities Track and maintain authorization requests in accordance with insurance guidelines Verify member insurance coverage and perform data entry for complex authorization requests Act as a...


  • San Diego, CA, United States VirtualVocations Full time

    A company is looking for a Prior Authorization Specialist to manage authorization requests for outpatient diagnostic and surgical services. Key Responsibilities Determine authorization requirements and escalate cases as needed Submit authorization requests and gather clinical data for insurance companies Follow up with physician offices and patients...


  • , MA, United States Lionstep AG Full time

    Job SummaryWe are seeking a highly skilled Reimbursement Authorization Specialist to join our team at Ajinomoto Cambrooke. As a key member of our Revenue Cycle Department, you will play a critical role in ensuring the accuracy of all necessary documentation and coordination with healthcare professionals, agencies, and payers to facilitate patient access to...


  • , IL, United States Addus HomeCare Full time

    Authorization Clerk Job DescriptionWe are seeking a highly organized and detail-oriented Authorization Clerk to join our team at Addus HomeCare. As an Authorization Clerk, you will play a critical role in ensuring that our patients receive the necessary authorizations for private insurance coverage.Key Responsibilities:Track and request all authorizations...