Insurance Benefits & Authorization Specialist – Technology

Insurance Benefits & Prior Authorization Specialist

Full-Time On-Site · Reports to Director of Revenue Cycle Management

About the Practice

This role depends on daily use of the EHR, payer portals, and available AI or automation tools to keep eligibility and authorization work accurate and current. Vein Institute of South Mississippi is a specialty varicose vein clinic focused exclusively on the evaluation and treatment of varicose veins of the legs. We have three locations and two providers. The Revenue Cycle team handles consistent insurance verification work with a defined, manageable prior authorization caseload.

Position Summary

The specialist uses practice technology and AI-assisted tools, with required human review, to complete insurance benefits and eligibility verification and to submit and track prior authorizations for scheduled vein procedures. This role is the first line of financial clearance before the patient is seen or treated. Accuracy, follow-through, and clear documentation in the EHR are essential. The specialist works directly with the Director of RCM.

Compensation/Benefits

• $23–$25/hourly, based on experience, education, certifications, and demonstrated use of healthcare technology and AI tools
• Benefits: health, dental, and vision insurance, 401(k) matching, PTO, paid holidays

Primary Responsibilities

• Use the EHR, payer portals, and available AI or automation tools to complete eligibility checks, organize worklists, draft or review authorization packets, and document findings; all AI-assisted output must be reviewed for accuracy before it is used or entered in the chart.
• Verify insurance eligibility and benefits for every scheduled patient prior to the visit, including coverage status, plan type, deductible, copay, coinsurance, out-of-pocket maximum, and remaining balances.
• Confirm medical versus cosmetic coverage and any plan exclusions related to varicose vein treatment of the legs.
• Check benefits against the typical procedure set for this specialty (generally five CPT codes per patient), including evaluation and management, diagnostic duplex ultrasound, endovenous ablation, phlebectomy, and sclerotherapy as applicable.
• Document verification results clearly in the EHR so front desk, clinical, and billing staff can act on the same information.
• Identify when prior authorization is required and prepare complete submissions (clinical notes, duplex findings, photographs when required, conservative therapy documentation, and medical necessity support).
• Submit prior authorizations by payer-preferred method (portal, fax, or phone) and track status through approval, pending, or denial.
• Manage a defined prior authorization volume of up to approximately 20 authorizations per month and escalate delays or denials to the Director of RCM promptly.
• Communicate benefit limitations, estimated patient responsibility, and authorization status to the appropriate internal team members so patients can be informed before service.
• Follow up on incomplete, pending, or expired authorizations and maintain an organized worklist so no scheduled procedure is missed.
• Stay current on payer-specific varicose vein policies (medical necessity criteria, vein laterality/staging rules, and documentation requirements).
• Support related RCM tasks as assigned, including eligibility re-checks after insurance changes and assistance with denial information related to authorization or benefits.

Workload Context

• Work is completed in the EHR and payer portals, with AI or automation tools used to support—not replace—daily verification and authorization tracking.
• Three locations and two providers, Monday through Friday.
• Benefits and eligibility verification is the core daily workload, typically covering about five CPT codes per patient.
• Prior authorization volume is capped at a maximum of approximately 20 submissions per month.
• Work is specialty-focused (varicose veins of the legs only), which allows the specialist to become highly proficient in a defined set of payers, codes, and medical-necessity rules.

Required Qualifications

• Experience using specialty-specific technology, payer policy tools, or AI-assisted coding and authorization resources in a procedure-based practice.
• Demonstrated experience using healthcare technology in daily RCM work, including EHR systems and payer portals, and hands-on use of AI or automation tools (AI-assisted documentation, eligibility or authorization workflow tools, or similar practice technology). Candidates must be comfortable adopting new systems and reviewing technology-assisted output for accuracy.
• Billing and coding degree, diploma, or certificate from an accredited program, or an active billing/coding certification (CPC, CPB, CCA, CCS, or equivalent).
• 2 years of experience in medical insurance verification, benefits investigation, and/or prior authorization in an outpatient or specialty setting.
• Working knowledge of commercial, Medicare, and Medicaid/managed care eligibility and authorization processes.
• Ability to read and apply payer medical policies and to match clinical documentation to authorization criteria.
• Strong attention to detail, organization, and follow-through; comfortable managing a daily worklist under time-sensitive scheduling deadlines.
• Clear written and verbal communication with internal staff and, when needed, payer representatives.
• Proficiency with EHR systems and payer portals. Experience with CureMD is a plus.

Preferred Qualifications

• Experience in vascular, vein, or other procedure-based specialty practices.
• Familiarity with common vein-related CPT codes (e.g., 99202–99215, 93970/93971, 36478/36479, 37765, 36470/36471) and related ICD-10 diagnosis coding.
• Knowledge of Mississippi commercial payers and Medicare Advantage plans commonly seen in the Hattiesburg market.

What Success Looks Like

• Technology and AI tools are used to support the work, with human review so notes, benefits, and authorizations remain accurate.
• Every scheduled patient has complete, documented benefits and eligibility information before the visit.
• Authorization is obtained (or a clear denial/alternative path is documented) before the procedure date whenever required.
• Worklists are current; nothing sits unworked past the same-day or next-business-day standard set by RCM leadership.
• Front desk and clinical teams can rely on the verification notes without having to re-check the same plan.

How to Apply

Submit a resume and a brief cover note that names the EHR systems, payer portals, and AI or automation tools used in prior insurance verification or prior authorization work to Human Resources at al@veinsms.com. Also describe insurance verification and prior authorization experience and list billing/coding credentials.

Vein Institute of South Mississippi is an equal opportunity employer.

Benefits

• Technology-supported role with training on practice systems, payer portals, and approved AI tools used in revenue cycle work
• 401(k)
• Dental insurance
• Health insurance
• Paid time off
• Vision insurance

Pay: $23.00 - $25.00 per hour

Benefits:

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

Application Question(s):

• Describe how you have used AI and other technology tools in your insurance verification, coding, or prior authorization workflow. Include the tools used and what part of the work they supported.
• How many years of hands-on experience do you have verifying insurance eligibility and benefits in an outpatient or specialty medical practice?
• Do you have experience submitting and tracking prior authorizations (portals, fax, and/or phone) for scheduled procedures?
• Have you verified benefits against specific CPT codes (not just “active/inactive coverage”)?
• Do you have experience in a procedure-based specialty (vein/vascular, cardiology, surgery, GI, pain, ortho, or similar)?
• Do you hold a billing and coding degree, diploma, certificate, or active certification (CPC, CPB, CCA, CCS, or equivalent)? Please list it.

Work Location: In person

Salary : $23 - $25