SHC WVUHS Home Care
Insurance Specialist III
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Job Description
- Req#: JR26-27210
Employer Industry: Healthcare Services
Why consider this job opportunity:
- Opportunity for career advancement and growth within the organization
- Work in a collaborative outpatient clinical environment
- Engage in meaningful work that supports patient care and financial clearance processes
- Utilize advanced systems like EPIC for managing workflows
- Participate in monthly team meetings to enhance team cohesion and performance
- Flexible work hours with a commitment to maintaining a healthy work-life balance
What to Expect (Job Responsibilities):
- Obtain authorizations for elective infusions and injections to ensure patient financial clearance
- Act as a liaison between clinical teams and pharmacists to facilitate communication on authorization issues
- Utilize EPIC system work queues to manage and prioritize workloads efficiently
- Verify authorization requirements and submit requests through insurance portals or direct communication
- Review medical documentation to provide accurate information during the authorization process
What is Required (Qualifications):
- High school graduate or equivalent with 2 years of experience in a medical environment, or an Associate’s degree with 1 year of experience
- Basic knowledge of medical terminology, ICD-10, and CPT coding
- Understanding of authorization processes and insurance guidelines
- Proficient in Microsoft Office applications
- Excellent communication and interpersonal skills
How to Stand Out (Preferred Qualifications):
- 3 years of experience in a medical environment with knowledge of medical terminology and coding
- Ability to prioritize tasks and manage a high volume of work with attention to detail
- Basic computer skills and familiarity with hospital communication systems
- Experience with denial management and obtaining retro authorizations
- Strong customer service skills and telephone etiquette
#HealthcareServices #PatientCare #Authorization #CareerGrowth #TeamCollaboration
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