Insurance Verification and Authorization Specialist (56080)

Health Solutions•Pueblo, CO

About The Position

Health Solutions is a whole-person wellness center with more than 400 employees in Southern Colorado. The full-time Insurance Verification and Authorization Specialist joins the Revenue Cycle department and verifies patient insurance coverage, obtains prior authorizations, and ensures approvals are in place before services are rendered. The role works with providers, insurance companies, and patients to support an efficient authorization process and accurate, timely billing. The position reports to the Director of Revenue Cycle Management.

Requirements

High school diploma or equivalent.
At least 3 years of relevant medical office experience and a basic understanding of billing processes.
Practical knowledge of payer-specific rules and regulations, including Medicaid and Medicare.
Excellent interpersonal and customer service skills.
Demonstrated experience in counseling, analysis, collaborative teamwork, professional communication and interactions, advocacy, financial management, and customer service.
Willingness to collaborate across multiple teams and tasks.
Proficiency with Windows-based computer programs, electronic charts, and basic office equipment.
Ability to multitask and prioritize in a fast-paced setting.
Strong organization, self-motivation, and time-management skills.
Strong verbal and written communication skills.

Nice To Haves

Experience with NextGen and MyAvatar electronic health record systems.
CAAS Certification.
Spanish language skills.

Responsibilities

Assist clients with insurance options and coverage, and direct them to available alternative community resources.
Verify insurance eligibility and active coverage, confirm insurance information and health benefits, and update charts with accurate copay information before scheduling.
Request authorizations when required by payers.
Assist clients with applications for Medicaid, other insurance benefits, outside assistance, and community services.
Ensure appropriate forms are completed accurately and on time.
Assist clients with sliding fee scale applications.
Provide financial counseling before treatment or when referred by other departments.
Discuss patient financial obligations and billing practices, assess financial hardship, and establish payment arrangements.
Record relevant client information in the electronic health record to support accurate billing of client balances.
Monitor overdue accounts and proactively collect outstanding balances.
Review self-pay accounts for submission to a collection agency.
Provide customer service with patience and understanding while applying company payment policies.
Maintain confidentiality of sensitive and protected information in accordance with HIPAA regulations.
Document the financial counseling process and its outcome, and forward relevant information to appropriate personnel and departments.
Perform other duties as assigned.

Benefits

Competitive pay of $18.08–$20.78 per hour, dependent on experience, certification, and shift.
Paid holidays and generous paid time off.
Employee assistance program.
Tuition reimbursement.
Retirement plan with employer match up to 6%.
Medical, dental, and vision insurance, with low deductibles.
Flexible spending account.
Premier wellness program and other wellness benefits.
Life and AD&D insurance and long-term disability coverage.
Additional voluntary insurance benefits, including voluntary life and pet insurance.
Childcare.
Flexible work schedule.
Employee recognitions and celebrations.
Warm and friendly work environment where staff respect and learn from one another.