Insurance Coordinator

Key Responsibilities:

• Obtain and track prior authorizations for medical and surgical procedures, ensuring timely approvals.
• Verify insurance coverage, benefits, and eligibility for patients.
• Communicate with insurance companies, providers, and patients to resolve authorization-related issues.
• Maintain accurate documentation of all authorization requests, approvals, and denials in electronic health records (EHR).
• Collaborate with physicians, nurses, and administrative staff to ensure seamless patient scheduling and care coordination.
• Appeal denied claims and follow up on pending authorizations to minimize delays in treatment.
• Stay up to date with insurance regulations, policy changes, and payer requirements.
• Provide patients with clear information about insurance coverage and authorization status.

Qualifications:

• Education: High school diploma or equivalent required; associate or bachelor's degree in healthcare administration or related field preferred.
• Experience: Minimum of 2-3 years of experience in medical insurance coordination, prior authorizations, or medical billing (experience with surgical pre-authorizations preferred).
• Skills & Knowledge:
• Strong understanding of medical insurance policies, CPT and ICD-10 coding, and pre-authorization procedures.
• Proficiency in EHR and practice management software.
• Excellent communication and problem-solving skills.
• Strong attention to detail and ability to multitask in a fast-paced environment.
• Knowledge of HIPAA and patient confidentiality regulations.

Work Environment:

• Office-based role in a healthcare setting.
• Regular interaction with medical staff, patients, and insurance providers.
• May require handling high volumes of authorization requests under tight deadlines.

Preferred Qualifications:

• Experience working in a hospital, surgical center, or specialty practice.
• Familiarity with Medicare, Medicaid, and private insurance pre-authorization guidelines.