Insurance Authorization Specialist II

🕒 June 17

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WVU Medicine

WebsiteLinkedInAll Job Openings

10,000+ employees

🏥 Healthcare

⚕️ Healthcare Insurance

Healthcare • Healthcare Insurance

WVU Medicine is a comprehensive health system affiliated with West Virginia University, providing medical services through a network of hospitals across West Virginia. The system includes notable facilities such as J. W. Ruby Memorial Hospital, WVU Medicine Children's, and various other regional medical centers. WVU Medicine offers a wide range of healthcare services, including specialized and advanced medical treatments such as robotic heart surgery. It's also involved in medical education, research, and community health initiatives, emphasizing a mission of delivering high-quality care to the communities it serves.

📋 Description

• Obtaining authorizations for elective procedures, services, and tests • Coding cases and reviewing clinical documentation • Escalating financial clearance risks as appropriate • Driving key goals of securing reimbursement and minimizing organizational write-offs • Ensuring timely follow-up on submitted authorization requests • Reviewing and interpreting medical record documentation during the authorization process • Assisting with denial management issues and obtaining retro-authorizations as needed • Maintaining compliance with departmental quality standards

🎯 Requirements

• High school graduate or equivalent with 2 years working experience in a medical environment • Associate’s degree and 1 year of experience in a medical environment required • 3 years’ experience of knowledge and interpretation of medical terminology, ICD-10, and CPT codes • Understanding of authorization processes, insurance guidelines, and third-party payors • Proficiency in Microsoft Office applications • Excellent communication and interpersonal skills • Ability to prioritize to meet deadlines and multitask a large work volume with a high level of efficiency and attention to detail • Basic computer skills

🏖️ Benefits

• Health insurance • 401(k) matching • Flexible work arrangements • Professional development opportunities