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Insurance Authorization Specialist
Solaris Health. Initiate and track insurance prior authorizations for scheduled procedures, imaging, and other medical services .
Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in insurance prior authorization processes, including verification of eligibility and benefits, while ensuring compliance with HIPAA and organizational policies. Proficient in EMR documentation and payer portal navigation, with strong communication and organizational skills to manage multiple authorizations effectively.
Highest-signal resume keywords
Insurance Prior AuthorizationEMR DocumentationPayer Portal ProficiencyHealthcare Billing ExperienceHIPAA Compliance
ATS Keywords
Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
Insurance VerificationMedical TerminologyData EntryAuthorization RequirementsContract Benefits Understanding
Soft Skills
Professional CommunicationOrganizational SkillsCustomer ServiceAnalytical SkillsProblem-Solving Skills
Tools & Technologies
EMR SystemsMicrosoft OfficePayer Portals
Certifications & Qualifications
Annual Compliance Training
Industry Keywords
Healthcare AdministrationBillingFinancial ClearancePatient ConfidentialitySolaris Health Code of Conduct
About the role
Key responsibilities & impact- Initiate and track insurance prior authorizations for scheduled procedures, imaging, and other medical services
- Verify insurance eligibility and benefits using payer portals or direct contact with payers
- Document authorization statuses accurately in the EMR and Practice Management system
- Obtain authorizations before scheduled dates of service to avoid delays or denials
- Escalate urgent or complex authorization cases to the Manager/Supervisor and Team Lead of Financial Clearance
- Support team objectives and participate in departmental huddles and workflow optimization initiatives
- Participate in ongoing training and feedback sessions
- Communicate with insurance carriers to gather clinical documentation and follow up on pending requests
- Identify and report recurring payer issues or trends to the Supervisor
- Inform patients about authorization status, potential delays, and coverage issues
- Coordinate with patient estimation staff so authorizations align with cost estimates and pre-service collections
- Perform other related duties as assigned
- Adhere to ethical standards, applicable laws, HIPAA requirements, the Solaris Health Code of Conduct, and organizational policies
- Report suspected compliance concerns or violations
- Complete Annual Compliance Training
Requirements
What you’ll need- High School Diploma or equivalent required
- Associate’s degree in healthcare administration, billing, or related field preferred
- Minimum 1 year of experience in medical office, insurance verification, or healthcare billing
- Familiarity with payer rules, authorization requirements, and EMR documentation preferred
- Comprehensive understanding of insurance verification, contract benefits and medical terminology
- Ability to follow policies and procedures and enter data into various electronic systems while maintaining data integrity and accuracy
- Professional verbal and written communication skills
- Proficient in payer portals, EMR systems, and Microsoft Office
- Excellent organizational skills and attention to detail
- Excellent customer service skills
- Strong analytical and problem-solving skills
- Able to work effectively under supervision and in a collaborative, team-oriented environment
- Detail-oriented, organized, and able to manage multiple authorizations simultaneously
- Must maintain patient confidentiality in compliance with HIPAA
- Must comply with applicable laws, regulations, Solaris Health Code of Conduct, and organizational policies and procedures
- Must complete Annual Compliance Training
Benefits
Comp & perks- Competitive pay
- PTO
- Holiday pay
- Comprehensive benefits package
- Health insurance
- Dental insurance
- Vision insurance
- Life Insurance
- Pet Insurance
- Health savings account
- Paid sick time
- Paid time off
- Paid holidays
- Profit sharing
- Retirement plan
- No weekends
- No evenings
- No holidays