Insurance Verification & Authorization Specialist

Insurance Verification & Authorization Specialist

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 visitsupporting both a positive patient experience and accurate reimbursement for services provided.

Schedule & Location: This role is fully onsite at our Austin HQ (5929 Balcones Drive, Austin, TX 78731). Monday-Thursday 8a-5p Friday 8a-12p (40 hour work week)

Key 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

Prior Authorizations and Referrals

• 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

Patient Financial Responsibility

• 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

Coordination with Internal Teams

• 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

Documentation

• 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

Skills, Knowledge and Expertise

• 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

Required Education and Experience

• 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)

Preferred Experience

• 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

Benefits

• Medical, Dental and Vision Insurance.
• Generous Paid Time Off and 10 Paid Holidays
• Free Allergy Testing and Discounted Treatments
• 401(k) + Generous Employer Match
• Employee rewards program!
• + More!

Aspire Allergy & Sinus is an Equal Employment Opportunity/Affirmative Action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law. Reasonable accommodations may be made to enable individuals with disabilities to perform essential functions.