Insurance Verification and Authorization Specialist
About The Position
Health Solutions is hiring a full-time Insurance Verification and Authorization Specialist for its Revenue Cycle department in Montebello, Pueblo, Colorado. The role verifies patient insurance coverage, obtains prior authorizations, and ensures approvals are in place before services are rendered. The specialist works with providers, insurers, and patients to streamline authorizations and support timely, accurate billing. The role also assists clients with insurance options and community resources, provides financial counseling, supports billing and collections processes, and completes reporting functions. 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
- Verify insurance eligibility, confirm coverage is active and information is correct, and update client charts with accurate benefit and copay information before scheduling.
- Request payer authorizations when required.
- Help clients complete applications for Medicaid, other insurance benefits, outside assistance, and community services.
- Ensure required 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.
- Explain 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 collection agencies.
- Provide customer service with patience and understanding while following company payment policies.
- Maintain confidentiality of sensitive and protected information in accordance with HIPAA regulations.
- Document financial counseling processes and outcomes and forward relevant information to appropriate personnel and departments.
- Perform reporting functions and other duties as assigned.
Benefits
- Paid holidays and generous paid time off.
- Employee Assistance Program (EAP).
- Tuition reimbursement.
- Retirement plan: 403(b) with employer match up to 6%.
- Medical, dental, and vision insurance with low deductibles.
- Flexible spending account (FSA).
- Wellness benefits and a premier wellness program.
- Life and AD&D insurance.
- Long-term disability insurance.
- Additional voluntary insurance benefits, including voluntary life and pet insurance.
- Childcare.
- Flexible work schedule.
- Employee recognition and celebrations.
- Warm and friendly work environment where staff respect and learn from one another.
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What This Job Offers
Job Type
Full-time
Education Level
High school or GED
