Health Insurance and Authorization Specialist II
Listed on 2026-02-28
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Healthcare
Healthcare Administration, Medical Billing and Coding
17818
TitleHealth Insurance and Authorization Specialist II
Job DescriptionHealth Insurance and Authorization Specialist II is responsible for assessing and performing quality control for all preadmission visits on surgical inpatient, short stay 23 (SS23), Endo and ambulatory procedures ensuring all pertinent information is on file and accurately documented. Activities include reviewing diagnosis and history for correct insurance coverage, verifying insurance eligibility and coverage using three patient identifiers, confirming prior authorization is on file for correct level of care, inquiring about prior auth denials and working with provider offices to resolve issues, requesting estimated cost and collecting deposits for non-covered services, ensuring appropriate medical justification is documented for out-of-network payers, referring self-pay patients to Financial Case Management for Medicaid assessment or financial assistance, reviewing and validating MSP questions, monitoring Medicare days for exhausted benefits, identifying and resolving coordination of benefits discrepancies, and notifying Utilization Management of additional clinical requests.
SalaryRange
$19.62 - $26.49 an hour
Job RequirementsHigh school Diploma or equivalent required. Associate degree preferred in related discipline (admitting/registration/patient billing/insurance) or equivalent experience.
Minimum 3 years of related experience preferably in a hospital setting, medical office billing and knowledge of third-party insurance regulations.
Require high degree of professionalism and motivation with excellent communication and customer service skills, medical terminology, good interpersonal and telephone skills, detail oriented. Computer, copier and fax skills.
Full-Time
Hours/Week40 hrs
CityRochester
Work ShiftDays
Area of InterestClerical
The Hospital is committed to equal opportunity for all persons regardless of age, color, disability, ethnicity, marital status, national origin, race, religion, sex, sexual orientation, veteran status, or any other status protected by law.
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