Remote Insurance Authorization Specialist

100% Remote 

Pay: $18-22/hour 

Our team assists healthcare providers with the remediation of 3rd party accounts receivable and a variety of revenue cycle outsource capabilities. 
We are seeking a highly organized and detail-oriented individual to join our team as a Remote Insurance Authorization Specialist. In this role, you will be responsible for obtaining prior authorizations from insurance companies for upcoming medical procedures, treatments, and services for patients while providing accountable oversight of assigned work que; processes procedures and projects in order to deliver superior productivity and quality outputs for the assigned client. You will work closely with our client, healthcare providers, insurance companies, and patients to navigate the authorization process efficiently. This position may transition to Accounts Receivable Representative for future projects, based on ongoing needs.

Responsibilities:

• Communicates with insurance companies to obtain prior authorizations for surgeries, imaging studies, procedures, and other services 
• Verifies insurance eligibility and benefit information 
• Initiates timely prior authorization requests with insurance plans either by phone or payer portal 
• Submits medical documentation needed to obtain prior authorizations 
• Requests medical records, updated orders, and insurance information from providers when appropriate 
• Monitors work list for urgent scheduling add-ons to secure prior authorizations 
• Coordinates peer-to-peer requests with insurance plans and the ordering providers 
• Demonstrates persistence when obtaining authorization status from insurance carriers 
• Updates the patient accounting system with authorization numbers for specified services and date spans 
• Notifies Scheduling and ordering providers of any delays or rescheduling needs due to payer delays 
• Understand payer policies related to authorization requirements and timeframes needed to obtain authorizations 
• Appropriately respond to phone calls, emails, and other forms of communication 
• Complies with governmental regulations in reference to healthcare, billing, the Health Insurance Portability and Accountability Act (HIPAA), the Joint Commission (TJC) standards, Centers for Medicare and Medicaid Services (CMS), Emergency Medical Treatment and Labor Act (EMTALA), as well as department policies and procedures 

• Provides courteous service to all stakeholders (patients, patient families, other department staff, etc.) by resolving stakeholder problems, responding to inquiries, and following-up and strengthen customer relationships 
• Assist in training of new hires as needed 
• Perform other duties as assigned or requested and job specifications can be modified or updated at any time 

• High School Diploma or equivalent 
• Proficient with Microsoft Office Products 
• Proficient typing and spelling 
• Proficient computer skills, multitasking with data entry while using multiple computer applications 
• Ability to provide high level of customer service, attention to detail, critical thinking, and have proficient written and verbal communication skills 

• Some college experience in healthcare, business, accounting and/or professional certification preferred 
• Associates degree and/or bachelor's degree in medical preferred 
• Prior authorization experience in a healthcare setting 
• Knowledge of ICD-10 and CPT codes as well as other medical terminology 
• Have an understanding and ability to communicate financial and insurance information 

TRC Talent Solutions is proud to be an Equal Opportunity Employer (EOE). All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.