USA Clinics Group is hiring an Insurance Verification and Prior Authorization Specialist to ensure patients receive timely access to care. In this key role, you will secure necessary authorizations and manage denials, directly impacting patient experience and clinic operations.
What You'll Do
- Review physician and patient documentation for Medical Necessity against insurance protocol requirements.
- Actively communicate authorization status to staff and direct rescheduling or cancellation if needed.
- Serve as the primary liaison for patients and offices regarding new, changed, or pending insurance authorizations.
- Work on 20+ denials per day, investigating and finding solutions promptly.
- Schedule STAT and emergent patients for outpatient diagnostic exams.
- Interact with patients, representatives, and physician offices to gather and ensure accuracy of demographic, billing, and clinical information.
- Produce and distribute required forms with precise patient details.
- Protect patient confidentiality and privacy, disclosing information only for professional purposes.
- Display a positive, collaborative attitude when interacting with all stakeholders.
What We're Looking For
- At least 2 years of prior experience handling benefit verification and prior authorizations in a healthcare setting.
- Knowledge of referrals and the ability to locate and contact PCP offices.
- Experience with a high volume of insurance verification and authorization submissions.
- Immaculate attention to detail and excellent proofreading skills.
- A high school diploma.
Nice to Have
- Billing and Coding or other related certifications.
Benefits & Compensation
- Compensation: $22-$30/hr
- Insurance: health, vision, and dental
- Paid training
- PTO & sick time
- 401k option
Work Mode
This role is onsite at our Northbrook corporate office.
USA Clinics Group is an equal opportunity employer.
