Pre-Authorization Specialist - Austin, TX at CPIhealth

Austin, Texas, United States -

Full Time

Start Date

Immediate

Expiry Date

22 May, 26

Salary

23.5

Posted On

21 Feb, 26

Experience

0 year(s) or above

Remote Job

Yes

Telecommute

Yes

Sponsor Visa

Skills

Insurance Eligibility Verification, Preauthorization, Utilization Review, Medical Necessity, Liaison, Customer Service, Medical Terminology, HIPAA Regulations, Organizational Skills, Analytical Skills, Problem-Solving Skills, Attention To Detail, Communication Skills, Priority Management, Teamwork

Industry

Medical Practices

Description

Description CPIhealth is a interventional pain practice with a multidisciplinary team dedicated to providing empathetic, compassionate and comprehensive care to individuals experiencing chronic pain. With state-of-the-art facilities, advanced technology, and a collaborative environment, we offer a platform for healthcare providers to excel in their specialties while making a profound difference in the lives of those we serve. As you consider your next career move, we invite you to join us in redefining pain management through innovation, expertise, and a commitment to improving patient outcomes. Together, we can shape the future of healthcare and positively impact countless lives. We are seeking a qualified, dependable, and detail-oriented individual to join our team as a full-time Pre-Authorization Specialist in Austin, TX. Responsibilities: Contact insurance carriers to verify patient’s insurance eligibility, benefits, and preauthorization requirements. Request, track and obtain pre-authorization from insurance carriers prior to the services being performed. Perform utilization review to ensure the patient meets medical necessity. Be a liaison between patients, insurance companies, and Ambulatory Surgical Centers. Notify scheduling staff of any conflicts with scheduled appointments. Communicate any insurance changes or trends to the Billing Manager that may be affecting denials. Accept, handle, and process incoming patient telephone inquiries using appropriate customer service skills, clarify and validate patient inquiries, questions or complaints and correct and update patient account information accordingly. Demonstrate and apply knowledge of medical terminology, high proficiency of general medical office procedures including HIPAA regulations. Performs all other duties as assigned to support the mission, values, and strategies of CPI Health. This job description should not be interpreted as an exhaustive list of responsibilities or as an employment agreement between the employer and the employee. The above statements are intended to describe the general nature and level of work performed by employees assigned to this classification and are subject to change as the employer's needs and the job change. Requirements High School Diploma or equivalent. At least one year of experience with insurance authorization process, preferably in an outpatient/clinic setting. Experience with medical terminology preferred. Working knowledge of Microsoft Office applications. Strong organizational, analytical, and problem-solving skills with sound judgment and attention to detail. Excellent verbal and written communication skills. Proven ability to manage multiple priorities and meet deadlines. Demonstrated professionalism and cooperative behavior when interacting with patients, peers, providers, management, and visitors. Ability to build and maintain positive relationships with patients, providers, insurance companies, and the general public Team-oriented with the ability to work both independently and collaboratively to deliver exceptional customer service. Comprehensive Benefits plan including: Medical, Dental, Vision insurance Paid Time Off (accrued) Flexible Spending Account for Health & Dependent Care Basic Life, Accidental Life, Supplemental Life Insurance Short Term & Long-Term Disability 401(k) with matching

Responsibilities

The specialist will contact insurance carriers to verify eligibility, track, and obtain necessary preauthorizations before services are rendered, while also performing utilization reviews to ensure medical necessity is met. This role involves acting as a liaison between patients, insurers, and ASCs, handling patient inquiries, and communicating insurance trends to the Billing Manager.