Insurance Authorization Specialist

Wichita, KS - USA

Monthly Salary: Not Disclosed

Posted on: 19 hours ago

Vacancies: 1 Vacancy

Job Summary

Key Tasks and Responsibilities:

Essential Functions:

Submit orders for prior authorization in accordance with payer requirements and clinic protocols.
Monitor authorization requests ensure timely approval and follow up proactively on pending or denied submissions.
Verify current insurance eligibility for all scheduled patients.
Determine patient qualification for coverage including benefits limitations out-of-pocket responsibilities and authorization requirements.
Request and collect necessary clinical documentation from providers staff or external sources to support authorization submissions.
Maintain accurate and compliant records of all authorization activities in the electronic health record (EHR) and related systems.
Coordinate with attorneys when patient cases require legal oversight or documentation.
Serve as a liaison between the clinic and the prior authorization automation system ensuring efficient workflow troubleshooting issues and communicating updates.
Collaborate with clinical and administrative teams to streamline processes and resolve coverage or authorization barriers.
Performs other duties as assigned.

Non-Essential Functions:

Actively supports and upholds the mission and core values of the Hospital.
Remains knowledgeable of and follows Hospital policies.
Always maintains confidentiality of patient and hospital information.

Experience Required:

Experience in medical insurance verification prior authorization or related healthcare administrative role.
Strong understanding of insurance plans medical benefits and authorization procedures.
Excellent communication organization and problemâsolving skills.
Ability to manage multiple tasks in a fast-paced environment with high accuracy.

Environmental and Physical Requirements:

Must be able to read and speak English fluently.
Cognitive skills for math reading computer skills and communication skills to interact effectively with the public and peers.
Vision requirements: near mid-range far and accommodation.
Hearing requirements: low medium and high-pitch sounds.
Minimal up and down activity may be required.
Job risks include exposure to computers for 6-7 hours per day with typing activities.
Lifting requirements: 20-30 pounds maximum.

Equal Employment Opportunity (EEO) & Americans with Disabilities Act (ADA) Statement:

Our hospital is committed to fostering an inclusive and diverse workplace. We provide equal employment opportunities to all employees and applicants without regard to race color religion sex sexual orientation gender identity national origin disability veteran status or any other characteristic protected by applicable law. Additionally we provide reasonable accommodation for qualified individuals with disabilities in the application and employment process. If you require assistance or accommodation due to a disability please contact Human Resources so that we may engage in an interactive process to determine appropriate accommodation.

Required Experience:

Key Tasks and Responsibilities:Essential Functions:Submit orders for prior authorization in accordance with payer requirements and clinic protocols.Monitor authorization requests ensure timely approval and follow up proactively on pending or denied submissions.Verify current insurance eligibility fo...