Authorized Insurance Verification Specialist | RMA/LPN, Graff

Join a dedicated healthcare team in the heart of the Midwest region, where your role as an Insurance Verification and Prior Authorization Specialist is vital to patient care. This position involves verifying patient insurance eligibility, determining benefits, and securing prior authorizations before scheduled exams.

Key Responsibilities

Obtain or assist in obtaining prior authorizations and precertifications from insurance payers for surgical, laboratory, and diagnostic imaging procedures. Efficiently manage multiple prior authorization requests simultaneously with accuracy. Document authorization decisions in clinical software following established policies.Communicate with insurance payers via phone and online portals to verify benefits and authorization status. Confirm member plan eligibility and benefits prior to processing requests. Utilize clinical knowledge and resources to support authorization processes.

Education

High school diploma or equivalent required. Completion of a Registered Medical Assistant or Licensed Practical Nurse program is preferred.

Experience

At least one year of clinical experience in a healthcare setting is required. Experience with insurance verification and prior authorization processes is preferred. Familiarity with medical terminology and CPT&ICD-9/10 coding is advantageous.

Requirements

Must hold a valid Licensed Practical Nurse license from Missouri or a Compact State, or be an accredited Registered Medical Assistant if applicable. Strong communication skills, both verbal and written, are essential. Ability to concentrate for extended periods and perform repetitive tasks is necessary. Physical ability to stand, walk, sit, and reach is required.

Working Conditions

Standard office environment with occasional exposure to noise, fumes, chemicals, and other hazards.

This role offers an opportunity to contribute meaningfully to a regional healthcare system serving a broad community in the Midwest.