Verification Authorization - Associate

Position Summary
Our Verification Authorization Associates verify active insurance coverage, obtain facility and specimen collection information required for billing in accordance with CMS regulations, contact insurance companies to secure required preauthorization, and contact facilities for medical records as needed. Ensure information is complete and accurate and apply knowledge of Medicare, Medicaid, and other Third-Party Payer requirements.

Job Responsibilities
- Identify ways to improve quality and monitor your own work to ensure quality standards are met.
- Answer provider, facility, and staff questions about insurance authorization requirements.
- Manage and assign daily/weekly tasks based on business need.
- Occasional peer-to-peer training.

Required Qualifications
- High school degree (or equivalent).
- 2+ years of office setting experience.
- Proficient in MS Office (Word, Excel, Outlook).
- Solid time management and organization.
- Ability to work with minimal guidance; proactive, self-starter.
- Flexibility to handle frequent changes.
- Strong knowledge of insurance processing, guidelines, and laws for all payers.
- Proficient in clinical documentation review aligned to insurance authorization requirements.
- Strong problem-solving skills.
- Maintains compliance with HIPAA and other healthcare regulations.
- Moderate knowledge of CPT and ICD-10.

Preferred Qualifications
- Bachelor’s degree with 3 years related experience, or 5 years related experience.
- Professionalism, strong communication to educate/influence, persistent follow-up, drive toward problem resolution.
- Service/quality/continuous improvement mindset; teamwork; customer service focus.

Other
- Willingness to work shift work, overtime, and occasional weekends/evenings/holidays.
- Pre-employment process includes criminal background check, drug screening, credit check (for certain positions), and reference verification.