Pre-Authorization Verification Specialist

JFCS is seeking a detail-oriented professional to join our team in a role focused on supporting patients and ensuring a smooth process for accessing healthcare services. This position involves working closely with patients, insurance providers, and internal teams to help ensure information is accurate and services are appropriately coordinated.

• Obtains and updated copies of patients' insurance cards and demographic information.

• Determines and verifies patient insurance eligibility, benefits, and coverage for AHCCCS, Medicaid, Medicare and third-party insurance coverage.

• Engages with patients to determine if services requested need prior authorization.

• Submits authorization requests and tracks approvals to ensure timely patient care.

• Communicates with insurance companies to resolve authorization issues and claim denials.

• Maintains accurate patient insurance records in the electronic medical record (EMR) system.

Qualifications

• Previous experience as an Eligibility Specialist and demonstrated ability to manage multiple insurance plans including third-party insurance, AHCCCS, Medicaid and Medicare plans.

• Capacity to work with clinical staff, providers and follow payer guidelines and HIPAA regulations

• Ability to work in a fast-paced environment and provide excellent customer service and maintain documentation accuracy.

• Bilingual Strongly Preferred

• Must Receive/Maintain DPS Fingerprint Clearance

• High School Diploma or GED

• Must be able to perform the essential functions of the job including prolonged sitting and in certain positions driving, lifting 20lbs, walking, standing, and executing dexterity with a keyboard or smart pad.