Insurance Specialist III
Job Description: • Obtain authorizations for elective infusions and injections • Verify accurate prior authorization requirements • Escalate financial clearance risks • Serve as liaison between clinical teams and pharmacists • Code cases and review clinical documentation • Collect and communicate outpatient benefit information • Research CPT codes for drugs/injections • Verify authorization requirements • Submit authorizations for outpatient requests • Review and interpret medical record documentation • Communicate with clinics for additional information • Follow up on submitted authorization requests • Assist Patient Financial Services with denial management issues • Maintain confidentiality according to policy • Participate in monthly team meetings and one-on-ones Requirements: • High school graduate or equivalent with 2 years working experience in a medical environment • Associate’s degree and 1 year of experience in a medical environment • 3 years’ experience of knowledge and interpretation of medical terminology, ICD-10, and CPT codes • Understanding of authorization processes, insurance guidelines, and third-party payors practices • Proficiency in Microsoft Office applications • Excellent communication and interpersonal skills • Ability to prioritize to meet deadlines and multitask a large work volume with a high level of efficiency and attention to detail • Basic computer skills Benefits: • No benefits mentioned in the job description. Apply tot his job