Medical Insurance and Authorization Specialist

USA Clinics Group is looking for an organized and motivated individual to join the team as our newest Insurance Verification/ Prior Authorization Specialist! This position performs the function of obtaining referrals, and/or authorizations prior to the service date for test, procedures, and admissions into the clinics.

Only candidates able to commute to the jobs on-site location (Northbrook, IL) Monday through Friday 5 days a week will be considered. Remote work is not an option.

• Reviews referring physician and patient documentation for Medical Necessity against insurance protocol requirements for pre-certification purposes
• Actively communicates with staff regarding status of authorization. Communicates the need for reschedule and/or cancellation if authorization not in-hand
• Directs liaison to offices and patients regarding new, changed, or pending insurance authorizations, as well as on-going education of changes in authorization requirements
• Responsible for scheduling STAT, emergent patients for outpatient diagnostic exams
• Interacts with patients, their representatives, physicians, physician office staff, and others to gather and ensure accuracy of demographic, billing and clinical information
• Produces and distributes required forms with accurate patient information
• Performs additional duties as assigned

Requirements

• High school graduate Required

• At least 2 years of prior experience in a health care setting handling benefit verification and prior authorizations Required
• Billing or coding certifications Preferred
• Strong computers skills and excellent typing skills
• Immaculate attention to detail and excellent proofreading skills
• Excellent Customer Service skills
• Strong data entry skills
• Excellent organizational skills

Benefits

• Health
• Vision
• Dental
• 401K
• PTO