Insurance Verification Specialist

We are looking for a detail-oriented Insurance Verification Specialist to support patient access and coverage verification for healthcare services.

Looking for candidates with prior authorization experience, preferably focused on medication prior authorizations.

Ideal candidates will have experience submitting authorization requests through payer portals and documenting/communicating within Epic.

Strong understanding of insurance verification, pharmacy or medical authorization workflows, and payer guidelines preferred.

Candidates should be detail-oriented, comfortable working in fast-paced healthcare environments, and able to effectively follow up on pending or denied authorizations.

Responsibilities:

• Review insurance benefits, referral conditions, and authorization guidelines to determine coverage requirements before scheduled services.

• Work through payer websites and communication channels to submit authorization requests and provide supporting clinical details when needed.

• Record verification and authorization outcomes in the patient record using accurate medical terminology and complete documentation.

• Update coverage information in health records to reflect the most current insurance details obtained during review activities.

• Arrange pre-authorizations, pre-certifications, and additional approvals for inpatient and outpatient services across multiple departments and care settings.

• Identify delays or obstacles that may affect authorization approval and escalate issues promptly to support continuity of patient care.

• Communicate clearly with internal teams, payers, and other stakeholders to resolve coverage questions and support service readiness.

• Participate in virtual training and follow established workflows, policies, and quality standards while handling assigned tasks.

Qualifications:

• Experience in customer service, insurance verification, healthcare support, or a related administrative role.
• Working knowledge of insurance plans, referrals, prior authorization processes, and medical coverage review.
• Ability to document accurately in patient records and maintain a high level of attention to detail.
• Strong verbal and written communication skills for interacting with payers, care teams, and support staff.
• Familiarity with Microsoft Office applications and web-based systems used for verification and documentation.
• Understanding of compliance expectations, policies, and procedures in a healthcare or regulated environment.
• Ability to manage multiple tasks, troubleshoot issues, and stay organized in a fast-paced setting.

Compensation

$18.00-$21.00 Hourly

About Us

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