About the role:

This position is part of our Operations team. This highly skilled and experienced Insurance Verification Specialist reports to the RCM Manager. The Authorization/Insurance Verification Specialist is responsible for obtaining authorizations and insurance verification for one of Jorie Healthcare's clients. The client is a multi-specialty (Dental, Medical, Optometry & Behavioral Health) clinic that operates across multiple states.

Location & Hours:

• This position is 100% remote position
• This is for an 8-hour-a-day shift, M-F, EST Time zone hours to be determined and agreed upon with the management staff.

Responsibilities:

• Verification of insurance information (eligibility and benefits)
• Submitting and monitoring of pre-authorizations
• Determining medical necessity and identifying any coverage concerns and working with clients and providers and billing to resolve authorization denials.
• Completing pre-registration as required by patient type and anticipated service.
• Incumbents work with staff and management throughout the revenue cycle, clinical teams, clients, providers as well as representatives from insurance carriers and government agencies.

Required Skills/Abilities

• Clinical Background Preferred 
• Precertification skills are required
• Knowledge of Insurance Plans (PPO, HMO, Medicare, Medicaid, Replacement Plans, Supplemental Plans)
• Verification of insurance information (eligibility and benefits)

MUST HAVES:

• • Two (2) years of pre-authorization work in one of the following areas: Medical, Ambulatory, Surgery, Inpatient Hospitalization
  • Two (2) years of insurance verification in one of the following areas: Medical, Ambulatory, Surgery, Inpatient Hospitalization

Education:

• High school diploma