Insurance Verification & Authorizations Specialist

Position Type: Full-Time | Healthcare Revenue Cycle

Position Summary: We are seeking an experienced Insurance Verification & Authorizations Specialist to manage front-end revenue cycle functions for an ambulatory surgery center and pain management practice. This onsite role is critical to ensuring accurate benefits verification, timely prior authorizations, and proactive follow-up across multiple payers and portals.

Key Responsibilities: Verify insurance eligibility, benefits, deductibles, co-insurance, and out-of-pocket maximums Obtain and track prior authorizations for surgical, interventional pain, and diagnostic procedures Perform authorization follow-up to ensure approvals are received prior to date of service Navigate and manage all major payer online portals (Medicare MACs, Medicaid, BCBS, UHC, Aetna, Cigna, Tricare, etc.)Enter and maintain accurate authorization and benefit data within HST Pathways Communicate authorization requirements and financial responsibility clearly to staff and patients Escalate delayed or denied authorizations and document outcomes Maintain compliance with payer-specific rules and timelines

Required Qualifications: Minimum 2–3 years experience in insurance verification and prior authorizations Hands-on experience with HST (HST Pathways) – required Strong working knowledge of ASC and pain management workflows Proven ability to use payer web portals efficiently and independently Familiarity with Medicare, Medicaid, and commercial payer authorization rules High attention to detail and strong follow-through skills Ability to manage multiple cases simultaneously in a fast-paced environment

Preferred Qualifications: Experience in an Ambulatory Surgery Center (ASC) setting Knowledge of interventional pain procedures, spine, ortho, or GI authorizations Prior experience working with Texas Medicaid and Medicare MACsUnderstanding of medical necessity and payer policy requirements Bilingual Spanish/English

What We Offer: Competitive compensation based on experience Stable, physician-led practice environment Collaborative onsite team culture