Insurance Authorization Coordinator

Iowa Digestive Disease Center•Clive, IA

1d•Onsite

About The Position

The Insurance Authorization Specialist at the Iowa Digestive Disease Center plays a critical role in our Accounts Receivable department, supporting our mission of delivering high-quality, patient-centered health care. This position is responsible for obtaining insurance authorizations and pre-certifications for procedures, diagnostic services, and referrals specific to gastroenterology and hepatology care. The specialist ensures timely and accurate communication with insurance providers and patients, facilitating smooth access to care while minimizing claim denials.

Requirements

Prioritize tasks to meet deadlines while managing multiple assignments simultaneously
Handle high-stress scenarios calmly and confidently, ensuring productive outcomes and preserving positive relationships
Communicate clearly and effectively in both verbal and written formats
Strong communication, problem-solving, and organizational skills
Capable of working efficiently in a fast-paced environment while maintaining attention to detail
Handle sensitive information with discretion and maintain confidentiality where required

Nice To Haves

Working knowledge of medical terminology, CPT/ICD-10 codes, and insurance processes preferred

Responsibilities

Determine and obtain required prior authorizations for GI-related services such as colonoscopies, endoscopies, infusion therapy, imaging (e.g., CT, MRI), and specialty medications
Coordinate pre-certifications with insurance companies, ensuring all required documentation (e.g., physician notes, procedure codes, diagnosis codes) is submitted accurately and promptly
Monitor and follow up on outstanding authorizations to ensure approvals are received before the scheduled date of service
Assist with obtaining retro-authorizations when necessary and help resolve insurance claim denials related to missing or incorrect authorization
Maintain current knowledge of payer-specific authorization requirements, including local and national carriers such as Medicare, Medicaid, Wellmark BCBS, and UnitedHealthcare
Maintain compliance with HIPAA and other regulatory requirements related to patient privacy and insurance handling
Collaborate with billing, scheduling, and clinical teams to support smooth patient workflows