Insurance Verification and Prior Authorization Specialist in Northbrook, IL
Posted 2025-05-17Insurance Verification and Prior Authorization Specialist - USA Clinics Group - Northbrook, IL - work from home job
Company: USA Clinics Group
Job description: USA Clinics Group is looking for an organized and motivated individual to join the team as our newest Insurance Verification/ Prior Authorization Specialist! This position performs the function of obtaining referrals, and/or authorizations prior to the service date for test, procedures, and admissions into the clinics.
Only candidates able to commute to the jobs on-site location (Northbrook, IL) Monday through Friday 5 days a week will be considered. Remote work is not an option.
Responsibilities
Reviews referring physician and patient documentation for Medical Necessity against insurance protocol requirements for pre-certification purposes.
Actively communicates with staff regarding status of authorization. Communicates the need for reschedule and/or cancellation if authorization not in-hand).
Directs liaison to offices and patients regarding new, changed, or pending insurance authorizations, as well as on-going education of changes in authorization requirements.
Responsible for scheduling STAT, emergent patients for outpatient diagnostic exams.
Interacts with patients, their representatives, physicians, physician office staff, and others to gather and ensure accuracy of demographic, billing and clinical information.
Produces and distributes required forms with accurate patient information.
Respects and protects the patients rights to confidentiality and privacy and discloses information only for the professional purposes which are in the patients best interests with full consideration of their legal rights.
Displays a positive attitude when interacting with providers office staff, providers and fellow employees.
Performs additional duties as assigned
Requirements
High school graduate required. Advanced education preferred.
At least 2 years of prior experience in a health care setting handling benefit verification and prior authorizations, required
Strong computers skills and excellent typing skills; 50wpm
Immaculate attention to detail and excellent proofreading skills
Excellent Customer Service skills
Strong data entry skills
Excellent organizational skills
Billing and Coding or other related certifications a big plus
Benefits
Health
Dental
Vision
401K
PTO
IND1
Expected salary: $41000 - 52000 per year
Location: Northbrook, IL
Job date: Sat, 23 Sep 2023 22:29:15 GMT
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