Insurance Verification & Authorization Specialist

Aspire Allergy & Sinus•Austin, TX

4d•Onsite

About The Position

Join Aspire Allergy & Sinus as an Insurance Verification & Authorization Specialist and play a key role in ensuring patients receive seamless care while supporting an efficient revenue cycle. In this role, you will verify patient insurance eligibility and benefits, obtain prior authorizations and referrals when required, and ensure patients are properly cleared prior to services being rendered. Working closely with Scheduling, Front Desk, Clinical Operations, and the Revenue Cycle team, you will help ensure services meet payer requirements and reduce authorization- and eligibility-related denials. Using payer portals, practice management systems, and communication with insurance carriers, you will verify benefits, secure authorizations, and provide estimated patient financial responsibility when appropriate. This position is an essential part of the front-end revenue cycle, helping confirm coverage and authorization requirements before the patient visit—supporting both a positive patient experience and accurate reimbursement for services provided.

Requirements

Knowledge of commercial, Medicare, and Medicaid insurance guidelines
Familiarity with payer portals and insurance carrier websites
Strong attention to detail and organizational skills
Excellent written and verbal communication skills
Ability to prioritize and manage multiple workflows and deadlines
Ability to work independently while collaborating with a team in a fast-paced environment
High school diploma or equivalent required
Healthcare, hospital, or medical office experience
Familiarity with insurance verification, eligibility checks, or authorization workflows
Experience working with EHR or practice management systems (NextGen, Athena, Epic, or similar)
1+ years of insurance verification or authorization experience in a healthcare setting
Working knowledge of CPT and ICD-10 codes
Experience working with payer portals for eligibility and authorization requests

Responsibilities

Verify patient insurance eligibility and benefits using payer portals and insurance carriers
Confirm coverage details including copays, deductibles, coinsurance, and service limitations
Review patient demographic and insurance information and make corrections within the practice management system as needed
Ensure insurance verification is completed accurately and within required timelines prior to scheduled services
Obtain prior authorizations and referrals when required by payer guidelines for scheduled services, procedures, or testing
Ensure all required information for authorization requests is available, including CPT codes, diagnosis codes, and supporting documentation
Track authorization requests and follow up with payers to ensure approval prior to the date of service
Confirm scheduled services have valid authorization when required by payer and procedure
Calculate estimated patient responsibility based on verified benefits and payer guidelines
Communicate expected out-of-pocket costs to patients when appropriate prior to services
Refer uninsured or underinsured patients to the Billing team for assistance or payment arrangements when needed
Collaborate with Scheduling, Front Desk, and Clinical Operations to ensure patients are properly cleared for scheduled services
Communicate authorization requirements, missing documentation, or insurance issues to appropriate staff
Assist internal teams with insurance-related questions that may impact scheduling or patient care
Document verification results, authorization details, and payer communications within the practice management system
Maintain accurate records of verification and authorization activity
Ensure proper tracking of authorization approvals and expiration dates