Insurance Verification Specialist

As a Prior Authorization Specialist, you will be responsible for researching patient member benefits, additional coverages, coverage limitations, and general coverage allowances to obtain the necessary authorizations and referrals for patient services. You will initiate and manage the prior authorization process for medical procedures, treatments, or medications. Ensuring all required documentation, including clinical notes, medical history, and supporting documents, are complete and accurate is a crucial part of your role. Additionally, you will process prior authorizations and referral requests in a timely manner, prior to the patient's services being rendered. Your key responsibilities will include: - Researching patient member benefits, additional coverages, coverage limitations, and general coverage allowances - Initiating and managing the prior authorization process for medical procedures, treatments, or medications - Ensuring all required documentation, including clinical notes, medical history, and supporting documents, are complete and accurate - Processing prior authorizations and referral requests in a timely manner Qualifications required for this role: - Bachelor's degree in any discipline - Minimum of 1 year experience in Pre-Authorization & eligibility, benefits - Strong knowledge of medical terminology, insurance policies, and healthcare reimbursement processes - Excellent communication, organizational, and problem-solving skills - Ability to work independently and collaboratively in a fast-paced, deadline-driven environment - Experience with eClinicalWorks will be an added advantage - Willingness to work the night shift (any 9 hours between 6:30 pm to 3:30 am) Please note that the salary for this position will be as per company policy.,