Insurance Specialist III - Remote

Overview

The Insurance Specialist III is responsible for obtaining authorizations for elective infusions and injections, ensuring financial clearance for patients, and maximizing reimbursement through effective communication with clinical teams and pharmacists.

In Short

• Responsible for obtaining authorizations for elective infusions and injections.
• Utilizes payor resources and reference materials for prior authorization requirements.
• Serves as a liaison between clinical teams and pharmacists.
• Codes cases and reviews clinical documentation for completeness.
• Manages workloads using the EPIC system.
• Communicates effectively with outpatient benefit information.
• Researches CPT codes for medications.
• Submits authorizations and follows up on requests.
• Participates in team meetings and one-on-ones.
• Maintains confidentiality in all communications.

Requirements

• High school graduate with 2 years of experience in a medical environment or an Associate’s degree with 1 year of experience.
• 3 years of experience with medical terminology, ICD-10, and CPT codes preferred.
• Understanding of authorization processes and insurance guidelines.
• Proficiency in Microsoft Office applications.
• Excellent communication and interpersonal skills.
• Ability to multitask and prioritize in a fast-paced environment.
• Basic computer skills required.

Benefits

• Competitive salary and benefits package.
• Opportunities for professional development.
• Supportive work environment.
• Access to health and wellness programs.
• Flexible working hours.