Insurance Verification & Authorizations Specialist
Job Description
Insurance Verification & Authorizations Specialist
Ambulatory Surgery Center
Location: Onsite – DFW Area
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 MACs
Understanding 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
