Insurance Authorization Specialist

Join Our Founding Team

Winkler Vascular Consulting is a new, independent vascular surgery practice opening in New Albany, Mississippi. We are seeking an experienced Insurance Verification & Prior Authorization Specialist to help patients receive timely access to necessary testing, procedures and surgical care.

This position will work closely with the vascular surgeon, clinical team, patients and insurance companies. The ideal candidate is resourceful, highly organized and persistent, with a strong understanding of insurance requirements and medical prior authorization processes.

No nights. No weekends.

Position Summary

The Insurance Verification & Prior Authorization Specialist is responsible for verifying patient insurance coverage and obtaining authorizations for diagnostic testing, procedures and surgeries. This individual will review documentation, communicate with insurance companies, monitor pending requests and assist with denials and appeals.

Because this is a new practice, the position will also help establish organized, efficient authorization workflows and payer reference resources.

Key Responsibilities

• Verify patients’ insurance eligibility, benefits and coverage before scheduled services.
• Review clinical documentation for completeness and alignment with payer medical-policy requirements.
• Submit authorization requests for vascular testing, procedures and surgeries through payer portals, by telephone or through other required channels.
• Prioritize authorization requests according to scheduled service dates and clinical urgency.
• Monitor pending requests and follow up regularly to prevent unnecessary delays in patient care.
• Document authorization numbers, effective dates, approved services and payer communications accurately in the electronic medical record.
• Review diagnosis and procedure information for completeness and notify the appropriate clinical team member of missing or inconsistent information.
• Communicate documentation requirements and payer guidelines to the physician and clinical staff.
• Coordinate the submission of clinical notes, imaging results and other supporting documentation.
• Help coordinate peer-to-peer reviews when required.
• Initiate and track reconsiderations or appeals for denied services.
• Notify the physician and scheduling team promptly of approvals, denials or additional payer requirements.
• Communicate authorization status and scheduling-related information to patients clearly and professionally.
• Maintain current reference information for payer policies, submission requirements and authorization processes.
• Assist patients and team members with insurance-related questions within the scope of the position.
• Protect the confidentiality of all patient, financial and practice information.
• Assist with additional billing, scheduling or administrative responsibilities as needed.
• Perform other related duties assigned by the physician or practice manager.

Required Qualifications

• At least one year of medical insurance verification, prior authorization or precertification experience
• At least one year of experience in a medical office, billing department or related healthcare setting
• High school diploma or equivalent
• Working knowledge of medical terminology
• Understanding of health insurance benefits, payer requirements and prior authorization processes
• Strong computer skills and experience using payer websites and electronic medical records
• Excellent attention to detail and follow-through
• Ability to manage multiple time-sensitive requests and deadlines
• Strong written, verbal and interpersonal communication skills
• Ability to maintain patient confidentiality and comply with HIPAA requirements
• Professional, dependable and patient-focused approach

Preferred Qualifications

• Two or more years of medical prior authorization experience
• Experience obtaining authorizations for surgeries, procedures or diagnostic imaging
• Experience in vascular surgery, general surgery, cardiology or another specialty practice
• Familiarity with medical billing, diagnosis codes and procedure codes
• Experience handling authorization denials, reconsiderations and appeals
• Proficiency with Microsoft Word and Excel

What We Value

• Accuracy and close attention to detail
• Persistence and proactive follow-up
• Compassionate, respectful patient service
• Dependability and personal accountability
• Clear, professional communication
• Teamwork and a willingness to help
• Integrity and responsible handling of confidential information

Benefits

• Consistent weekday schedule
• No nights or weekends
• Health insurance
• 401(k)
• Paid vacation and time off
• Competitive Benefits Package

Winkler Vascular Consulting is an equal opportunity employer. Employment decisions are made without regard to race, color, religion, sex, national origin, age, disability, veteran status or any other characteristic protected by applicable law.

This description is intended to summarize the primary responsibilities of the position. Duties and responsibilities may change as the needs of the practice evolve.

Pay: From $24.00 per hour

Benefits:

• 401(k)
• Health insurance
• Paid time off

Experience:

• Authorizations: 1 year (Required)
• vascular: 1 year (Preferred)

Work Location: In person