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Insurance Authorization Specialist
2 months ago
We are seeking a highly skilled Insurance Authorization Representative to join our team at Advocate Health. As a key member of our patient access team, you will play a critical role in ensuring that patients receive the necessary physician or medical services by maintaining, confirming, and securing referrals, authorizations, or pre-certifications.
Key Responsibilities- Maintain accurate and complete patient account information, verifying the accuracy and completeness of patient data.
- Collaborate with internal departments to provide account status updates, coordinate the resolution of issues, and appeal denied authorizations.
- Educate patients, staff, and providers regarding referral and authorization requirements, payer coverage, eligibility guidelines, documentation requirements, and insurance-related changes or trends.
- Ensure all services have prior authorizations and update patients on their pre-authorization status.
- Coordinate peer-to-peer review if required by insurance.
- Typically requires 1 year of experience in providing customer service, including experiences in patient accounts, third-party payer plans, accounts receivable/collection processes, and medical clinic processes and workflow.
- Knowledge of third-party payers and pre-authorization requirements.
- Understanding of basic human anatomy, medical terminology, and procedures for application in the patient referral/pre-certification/authorization processes.
- Intermediate computer skills, including use of Microsoft Office (Excel and Word), electronic mail, physician practice management, and electronic medical records systems.
This is a full-time position, Monday through Friday, 8 hours daily, with an 8am or 8:30am start. No licenses or certifications are required, and a high school graduate is preferred.
