Job Summary
The Insurance Specialist II is responsible for overseeing specialty referrals, managing the coordination of diagnostic tests, and handling prior authorizations across various outpatient practices. This position serves as a crucial link among patients, healthcare providers, and insurance companies to facilitate effective care coordination and maintain precise insurance documentation.
Responsibilities
- Oversee and manage specialty referrals to ensure appropriate patient care.
- Coordinate diagnostic testing to streamline the process for patients and providers.
- Handle prior authorizations, ensuring compliance with insurance requirements.
- Act as a liaison between patients, healthcare providers, and insurance companies.
- Ensure accurate documentation for insurance claims and provider communication.
Qualifications
- High school diploma or equivalent is required.
- Minimum of two years of relevant experience in a physician’s office or outpatient setting.
- Strong understanding of medical terminology and insurance guidelines.
- Proficiency in using electronic medical record (EMR) systems.
UPMC provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.
