Prior authorization and Insurance specialist

Job Accountabilities

This position is responsible for insurance verification and authorization processing for transplant patients. Under the direction of the Transplant Financial Coordinator Supervisor, the Transplant Financial Coordinator (TFC) is a key member of the multidisciplinary transplant team.

Job Responsibilities

• Verify insurance benefits and obtain authorizations to ensure transplant patients receive financial clearance.
• Counsel patients regarding insurance coverage and provide guidance when coverage has lapsed or is insufficient.
• Analyze complex insurance information and communicate financial requirements to patients and staff.
• Resolve insurance-related issues and support process improvements that enhance patient care.
• Work with the multidisciplinary transplant team to support transplant financial coordination.

Required Qualifications

• Professional appearance with excellent communication skills.
• Hospital or clinical healthcare experience.
• Working knowledge of medical insurance verification and authorization processes.
• Strong computer and data entry skills.
• High School Diploma or equivalent required.
• Associate's Degree in a related field preferred.
• An Associate's Degree may be substituted with two (2) years of financial experience,

Preferred Qualifications

• Experience in the medical field, including transplant and transplant finance.

Bilingual fluency is strongly preferred.