Align is looking for an Insurance Specialist to manage the critical process of securing authorizations for patient services. This role is responsible for assuring all appointments and procedures are authorized, working directly with insurance carriers and patients to verify coverage and clarify financial responsibilities.

What You'll Do

Identify all patients requiring pre-certification or pre-authorization at the time services are requested.
Contact insurance companies or employers to determine eligibility and benefits for requested services.
Follow up with patients, insurance companies, or providers to resolve insurance coverage issues.
Use work queues within the EPIC system for scheduling, transition of care, and billing edits.
Perform medical necessity screening as required by third-party payors.
Document referrals, authorization, and certification numbers in the EPIC system.
Initiate charge anticipation calculations and accurately identify anticipated charges and patient self-pay portions.
Communicate anticipated self-pay portions to patients and refer self-pay patients to in-house Financial Counselors.
Assist Patient Financial Services with denial management issues and appeal denials based on medical necessity.
Assess all self-pay patients for potential public assistance and provide financial counseling information.
Maintain current knowledge of major payor payment provisions.

What We're Looking For

High school diploma or equivalent.
Ability to pass a state criminal background check and Federal check (if applicable), as required for regulated areas.