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Insurance Authorization and Eligibility Coordinator

Job in Odenton, Anne Arundel County, Maryland, 21113, USA
Listing for: Greater Maryland Pain Management
Full Time position
Listed on 2026-10-11
Job specializations:
  • Healthcare
    Healthcare Administration, Medical Billing and Coding, Medical Office, Medical Receptionist
Salary/Wage Range or Industry Benchmark: 42000 - 60000 USD Yearly USD 42000.00 60000.00 YEAR
Job Description & How to Apply Below
  • This position is responsible for obtaining and completing all insurance pre-certifications and authorizations as required for various clinical procedures.
  • Determines necessity for pre-certification and coordinates with insurance companies, patients and clinical staff to obtain information.
  • Maintains complete and accurate documentation in patient charts.
  • Develops and maintains effective relations with insurance companies, physicians and medical office staff.
  • Must have proficient knowledge of insurance requirements, medical/clinical terminology, medical necessity associated with various clinical procedure codes and certification/referral work flow.
  • This position requires the ability to work with minimal supervision.
  • Monitor new patient report and maintain organized list with status of pre-certification process.
  • Verify insurance eligibility and benefits via phone and/or internet access. Update insurance policy information.
  • Check insurance payment policy for scheduled procedures and obtain prior authorization when required.
  • Verify receipt of all necessary pre-authorization documents prior to procedure
  • Communicate effectively with the facility in which the procedure will be performed as needed.
  • Assign appropriate ICD and CPT codes pre-operatively based on documentation and booking slips.
  • Notify primary care physician for managed care plans that require PCP authorization.
  • Serve as a resource on insurance, billing and customer service for reception.
  • Perform other duties or functions as assigned
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