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 visit—supporting both a positive patient experience and accurate reimbursement for services provided.Schedule & LocationThis role is fully onsite at our Austin HQ (5929 Balcones Drive, Austin, TX 78731).Monday-Thursday 8a-5pFriday 8a-12p(40 hour work week)Key ResponsibilitiesInsurance VerificationVerify patient insurance eligibility and benefits using payer portals and insurance carriersConfirm coverage details including copays, deductibles, coinsurance, and service limitationsReview patient demographic and insurance information and make corrections within the practice management system as neededEnsure insurance verification is completed accurately and within required timelines prior to scheduled servicesPrior Authorizations and ReferralsObtain prior authorizations and referrals when required by payer guidelines for scheduled services, procedures, or testingEnsure all required information for authorization requests is available, including CPT codes, diagnosis codes, and supporting documentationTrack authorization requests and follow up with payers to ensure approval prior to the date of serviceConfirm scheduled services have valid authorization when required by payer and procedurePatient Financial ResponsibilityCalculate estimated patient responsibility based on verified benefits and payer guidelinesCommunicate expected out-of-pocket costs to patients when appropriate prior to servicesRefer uninsured or underinsured patients to the Billing team for assistance or payment arrangements when neededCoordination with Internal TeamsCollaborate with Scheduling, Front Desk, and Clinical Operations to ensure patients are properly cleared for scheduled servicesCommunicate authorization requirements, missing documentation, or insurance issues to appropriate staffAssist internal teams with insurance-related questions that may impact scheduling or patient careDocumentationDocument verification results, authorization details, and payer communications within the practice management systemMaintain accurate records of verification and authorization activityEnsure proper tracking of authorization approvals and expiration datesSkills, Knowledge and ExpertiseKnowledge of commercial, Medicare, and Medicaid insurance guidelinesFamiliarity with payer portals and insurance carrier websitesStrong attention to detail and organizational skillsExcellent written and verbal communication skillsAbility to prioritize and manage multiple workflows and deadlinesAbility to work independently while collaborating with a team in a fast-paced environmentRequired Education and ExperienceHigh school diploma or equivalent requiredHealthcare, hospital, or medical office experienceFamiliarity with insurance verification, eligibility checks, or authorization workflowsExperience working with EHR or practice management systems (NextGen, Athena, Epic, or similar)Preferred Experience1+ years of insurance verification or authorization experience in a healthcare settingWorking knowledge of CPT and ICD-10 codesExperience working with payer portals for eligibility and authorization requestsBenefitsMedical, Dental and Vision Insurance.Generous Paid Time Off and 10 Paid HolidaysFree Allergy Testing and Discounted Treatments401(k) + Generous Employer MatchEmployee rewards program!+ More! Explore More About AspireInstagram - https://www.instagram.com/aspireallergy/LinkedIn - https://www.linkedin.com/company/aspire-allergy/mycompany/TikTok – https://www.tiktok.com/@aspireallergyAspire 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.