Pre-Authorization Verification Specialist

JFCS is seekinga detail-oriented professional tojoin our teamin a rolefocusedon supporting patient sand ensuring asmooth process foraccessing healthcare services. This position involves working closely with patients, insuranceproviders, 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.