Tennessee Staffing
Insurance Authorization Specialist
Tennessee Staffing, Johnson City, Tennessee, United States, 37603
Insurance Authorization Specialist
Are you passionate about making a real difference in patients' lives? The Vein Company is seeking an Insurance Authorization Specialist to join our growing company. The ideal candidate will be responsible for verifying, processing, and obtaining approval for surgical procedures from insurance companies. We are passionate about delivering best in class care with cutting edge technology to our patients and believe that every member of our team plays a vital role in accomplishing this goal. Key Responsibilities Verify insurance coverage and eligibility for procedures via phone and online portals. Submit and track prior authorization requests for multiple providers. Communicate with insurance representatives, providers, and patients to gather required information. Follow up on pending requests, resolve delays, and address any denied authorizations. Review denial reasons, identify causes, and prepare accurate, timely appeals (including setting up peer-to-peer reviews when needed). Maintain detailed documentation of all authorization activities. Manage authorization deadlines to ensure timely patient care. Handle incoming and outgoing insurance calls. Cross train for front office to provide support if needed. Review and apply insurance guidelines for varicose vein treatments based on each patient's specific insurance plan. Qualifications 1-2 years of prior authorization or referral processing experience (vascular disease knowledge preferred). Strong understanding of commercial insurance, Medicare, and Medicaid, including key differences. Experience using insurance portals (e.g., Availity, UHC portal). Knowledge of medical terminology; familiarity with ICD-10 codes, CPT codes, and HIPAA regulations. Proficient in EMR systems and Microsoft Office 365. Highly organized, detail-oriented, and able to manage a high patient volume. Strong communication skills for discussing benefit coverage and authorization status with patients. Comfortable with extended hold times when calling insurance companies.
Are you passionate about making a real difference in patients' lives? The Vein Company is seeking an Insurance Authorization Specialist to join our growing company. The ideal candidate will be responsible for verifying, processing, and obtaining approval for surgical procedures from insurance companies. We are passionate about delivering best in class care with cutting edge technology to our patients and believe that every member of our team plays a vital role in accomplishing this goal. Key Responsibilities Verify insurance coverage and eligibility for procedures via phone and online portals. Submit and track prior authorization requests for multiple providers. Communicate with insurance representatives, providers, and patients to gather required information. Follow up on pending requests, resolve delays, and address any denied authorizations. Review denial reasons, identify causes, and prepare accurate, timely appeals (including setting up peer-to-peer reviews when needed). Maintain detailed documentation of all authorization activities. Manage authorization deadlines to ensure timely patient care. Handle incoming and outgoing insurance calls. Cross train for front office to provide support if needed. Review and apply insurance guidelines for varicose vein treatments based on each patient's specific insurance plan. Qualifications 1-2 years of prior authorization or referral processing experience (vascular disease knowledge preferred). Strong understanding of commercial insurance, Medicare, and Medicaid, including key differences. Experience using insurance portals (e.g., Availity, UHC portal). Knowledge of medical terminology; familiarity with ICD-10 codes, CPT codes, and HIPAA regulations. Proficient in EMR systems and Microsoft Office 365. Highly organized, detail-oriented, and able to manage a high patient volume. Strong communication skills for discussing benefit coverage and authorization status with patients. Comfortable with extended hold times when calling insurance companies.