Pre-Authorization Verification Specialist, Healthcare Insurance & Eligibility
Overview
Own patient access workflow at scale, ensuring fast, accurate eligibility and authorization for AHCCCS, Medicaid, Medicare, and third-party plans. Work with patients, insurers, and clinical teams to coordinate care and maintain precise EMR records. Manage prior authorization submissions and resolve issues to support timely patient care. This role sits on-site in Phoenix and collaborates across departments to maintain HIPAA-compliant processes. What makes this role different is direct impact on patient access and care coordination through rigorous eligibility verification and authorization tracking.
What You'll Do7
- 1Build and submit prior authorization requests and track approvals to ensure timely patient care
- 2Design processes to verify patient insurance eligibility, benefits, and coverage across multiple plans AHCCCS Medicaid Medicare
- 3Maintain accurate patient insurance records in the EMR and ensure data integrity
- 4Communicate with insurance companies to resolve authorization issues and claim denials
- 5Coordinate with clinical staff to confirm payer guidelines and ensure services align with authorization requirements
- 6Engage with patients to gather necessary information and verify demographic data
- 7Support documentation accuracy and compliance with HIPAA regulations
Requirements7
- 1High School Diploma or GED
- 2Previous experience as an Eligibility Specialist
- 3Ability to manage multiple insurance plans including third-party insurance AHCCCS Medicaid Medicare
- 4Capacity to work in a fast-paced environment and provide excellent customer service
- 5Bilingual Strongly Preferred
- 6Must Receive/Maintain DPS Fingerprint Clearance
- 7Ability to perform essential functions including prolonged sitting, driving, lifting 20lbs, walking, standing, and keyboard dexterity
Salary Insight
$35 - $37k per year
Location
Required Skills
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