Authorization and Insurance Payment Collector

OVERVIEW:

The Medical Authorizations and Insurance Collections Specialist is responsible for managing and coordinating insurance-related processes to ensure timely authorization of medical services and accurate reimbursement for services rendered. This role plays a critical part in supporting clinical operations by securing prior authorizations, monitoring payer requirements, and following up on outstanding insurance claims to optimize revenue cycle performance.

The ideal candidate is detail-oriented, highly organized, and experienced in navigating payer guidelines, authorization workflows, and insurance follow-up processes. Strong communication skills and the ability to collaborate with clinical teams, billing departments, and insurance carriers are essential.

ESSENTIAL DUTIES AND RESPONSIBILITIES:

· Obtain and manage prior authorizations for procedures, imaging, injections, and treatments in accordance with payer guidelines

· Verify insurance eligibility, benefits, and coverage requirements prior to scheduled services

· Educate patients on their financial responsibilities prior to services

· Communicate with insurance carriers to resolve authorization issues, denials, and delays

· Track authorization approvals, expiration dates, and required documentation

· Coordinate with clinical staff to ensure documentation supports medical necessity

· Follow up on outstanding insurance claims, denials, and underpayments

· Management insurance payments to confirm reimbursement per fee schedule

· Appeal denied claims and provide supporting documentation as needed

· Maintain accurate records within the practice management and EHR systems

· Ensure compliance with payer policies, regulatory requirements, and internal workflows

· Collaborate with billing, coding, and clinical teams to optimize revenue cycle efficiency

QUALIFICATIONS

· Prior experience in medical authorizations, insurance verification, or revenue cycle management

· Strong knowledge of insurance plans, payer guidelines, and authorization processes

· Familiarity with CPT, ICD-10, and medical terminology

· Excellent organizational, communication, and problem-solving skills

· Ability to manage multiple priorities in a fast-paced healthcare environment

· Experience with EHR and practice management systems preferred (AthenaOne)

PHYSICAL DEMANDS - The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

· The employee must frequently sit for long periods of time managing phones, computer inquiries

· Required to write and type for long periods of time

· While performing the duties of this job, the employee is regularly required to stand, walk, sit, and talk or hear.

· While performing the duties of this job, the employee is frequently required to use hands to finger, handle, or feel and reach with hands and arms.

Pay: $22.00 - $25.00 per hour

Benefits:

• 401(k)
• Dental insurance
• Disability insurance
• Health insurance
• Life insurance
• Paid time off
• Vision insurance

Work Location: In person

Salary : $22 - $25