Authorization​/Insurance Verification Spec.

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Full Time Honolulu, HI, US

2 days ago Requisition

Salary Range: $18.00 To $23.00 Hourly

Authorization/Insurance Verification Specialist

Founded in 1967, Waikiki Health is a nonprofit, Federally Qualified Health Center (FQHC) that offers a Patient-Centered Medical Home targeting our community’s most vulnerable populations. Our clinical and program sites provide holistic care in welcoming, supportive, and nonjudgmental environments. Waikiki Health’s mission is to provide quality medical and social services that are accessible and affordable for everyone, regardless of ability to pay.

Our Values

• We are committed to providing the highest quality care and services to our island community.
• We believe that respect is the foundation of our interpersonal relationships.
• We maintain empathy and kindness, treating everyone as ohana.
• We are creative and flexible in meeting community needs.
• We will help empower others to reach their highest potential.
• We are accountable to the community we serve and to each other.

Waikiki Health is seeking a full-time Authorization/Insurance Verification Specialist.

Pay rate for this role is $18 - $23 per hour (depending on experience)

Schedule:

• Monday – Friday: 8:00 AM – 5:00 PM
• Saturday: 8:00 AM – 12:00 PM (Rotating, on an as-needed basis)
• Health insurance (Employee only) 100% premium paid once eligible.
• 13 Paid holidays
• Parking included
• 403(b) Retirement Plan Participation effective within 4 weeks of employment
• Matching is offered once eligible with a 3-year vesting period
• Company Shirt

Summary of position: Waikiki Health is seeking a Revenue Cycle Financial Counselor to optimize professional billing, collections, and accounts receivable workflows. In this role, you will secure revenue integrity by verifying patient insurance, confirming primary care provider status, and obtaining service authorizations. You will also collaborate directly with executive leadership on critical financial projects – including the annual HRSA Uniform Data System (UDS) Report – while providing exceptional cross-functional support to clinical and administrative staff.

Qualifications and abilities

• High school diploma or equivalent, a minimum of 2 years of experience in medical billing and or follow up with all types of insurance carriers including Medicare and Medicaid. Complete understanding of AR and PMS system.
• Familiarity of Microsoft Office programs, including, but not limited to, Excel and Outlook.
• Knowledge of current Billing Operating System (Athena)
• Verifies insurance and PCP assignments at least 3 days prior to the set appointment.
• Communicates in a clear and timely manner with the Director of Revenue Cycle.

General Duties include but are not limited to

• Insurance Verification & PCP Alignment: Verifies insurance eligibility, confirms Primary Care Provider (PCP) designations, and contacts patients directly to gather missing details or facilities calls to update PCP status prior to appointments.
• Prior Authorization Management: Proactively reviews patient schedules to identify, submit, and secure all required medical and service authorizations before patients are seen by providers.
• Athena Net EHR Management & Problem Solving: Utilizes deep system knowledge to research, troubleshoot, and resolve upstream and downstream revenue cycle issues directly within the Athena Net planform.
• Executive Projects & Compliance Reporting: Executes specialized financial research and data projects directly by the CFO and Director of Revenue Cycle, including the preparation of critical HRSA UDS Report tables.
• Cross-Functional Communication & Staff Training: Educates patients, staff, and payers on complex financial processes, creates clinical communication cases for data corrections, and assists with training new revenue cycle employees.
• Other duties as assigned

* Waikiki Health requires proof of the following immunization; with or without reasonable accommodation: TB skin test or chest x-ray, Hep B (optional).

Those requiring assistance are encouraged to reach out to our organization at . Visit our website for more information:(Use the "Apply for this Job" box below)..org

Waikiki Health is an Equal Opportunity Employer that does not discriminate on the basis of actual or perceived race, color, creed, religion, national origin, ancestry, citizenship status, age, sex or gender (including pregnancy, childbirth and pregnancy-related conditions), gender identity or expression (including transgender status), sexual orientation, marital status, military service and veteran status, physical or mental disability, genetic information, or any other characteristic protected by applicable federal, state or local laws and ordinances.