Insurance Authorization Specialist

Surgery Partners, Inc • Wichita, KS

2d

About The Position

Key Tasks and Responsibilities:

 Essential Functions:

Submit orders for prior authorization in accordance with payer requirements
and clinic protocols.
Monitor authorization requests ensure timely approval and follow up
proactively on pending or denied submissions.
Verify current insurance eligibility for all scheduled patients.
Determine patient qualification for coverage, including benefits,
limitations, out-of-pocket responsibilities, and authorization requirements.
Request and collect necessary clinical documentation from providers, staff,
or external sources to support authorization submissions.
Maintain accurate and compliant records of all authorization activities in
the electronic health record (EHR) and related systems.
Coordinate with attorneys when patient cases require legal oversight or
documentation.
Serve as a liaison between the clinic and the prior authorization automation
system, ensuring efficient workflow, troubleshooting issues, and
communicating updates.
Collaborate with clinical and administrative teams to streamline processes
and resolve coverage or authorization barriers.
Performs other duties as assigned.

 Non-Essential Functions:

Actively supports and upholds the mission and core values of the Hospital.
Remains knowledgeable of and follows Hospital policies.
Always maintains confidentiality of patient and hospital information.

Requirements

• Experience in medical insurance verification, prior authorization, or related healthcare administrative role.
• Strong understanding of insurance plans, medical benefits, and authorization procedures.
• Excellent communication, organization, and problem‑solving skills.
• Ability to manage multiple tasks in a fast-paced environment with high accuracy.
• Must be able to read and speak English fluently.
• Cognitive skills for math, reading, computer skills, and communication skills to interact effectively with the public and peers.
• Vision requirements: near, mid-range, far, and accommodation.
• Hearing requirements: low, medium, and high-pitch sounds.
• Minimal up and down activity may be required.
• Job risks include exposure to computers for 6-7 hours per day with typing activities.
• Lifting requirements: 20-30 pounds maximum.

Responsibilities

• Submit orders for prior authorization in accordance with payer requirements and clinic protocols.
• Monitor authorization requests ensure timely approval and follow up proactively on pending or denied submissions.
• Verify current insurance eligibility for all scheduled patients.
• Determine patient qualification for coverage, including benefits, limitations, out-of-pocket responsibilities, and authorization requirements.
• Request and collect necessary clinical documentation from providers, staff, or external sources to support authorization submissions.
• Maintain accurate and compliant records of all authorization activities in the electronic health record (EHR) and related systems.
• Coordinate with attorneys when patient cases require legal oversight or documentation.
• Serve as a liaison between the clinic and the prior authorization automation system, ensuring efficient workflow, troubleshooting issues, and communicating updates.
• Collaborate with clinical and administrative teams to streamline processes and resolve coverage or authorization barriers.
• Performs other duties as assigned.
• Actively supports and upholds the mission and core values of the Hospital.
• Remains knowledgeable of and follows Hospital policies.
• Always maintains confidentiality of patient and hospital information.

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: No Education Listed