Insurance Verification & Authorization Specialist

Insurance Verification & Authorization Specialist

Job Category: Clinical

Requisition Number: INSUR
001606

• Posted :
  July 28, 2025
• Full-Time
• On-site

Showing 1 location

Columbia, MD 21044, USA

• Pay or shift range: $17 USD to $20 USD The estimated range is the budgeted amount for this position. Final offers are based on various factors, including skill set, experience, location, qualifications and other job-related reasons.

Position Summary/Scope of Responsibility

The Centers for Advanced Orthopaedics LLC (CAO) is one of the nation’s largest Orthopaedics practices, owned and operated by physicians, with over 60 locations across Maryland, Northern Virginia, and the District of Columbia. With approximately 2,000 employees, working in 28 Divisions, CAO is a growing business with revenues of approximately $250 Million. CAO is committed to be the Orthopaedics provider of choice for our patients;

partner of choice for payors and health systems; and employer of choice by attracting and retaining a talented workforce.

The Insurance Verification & Authorization Specialist is responsible for performing a variety of patient registration, and insurance verification duties. Responds to routine inquiries regarding online and in office scheduling. Drives requests, tracking, and obtaining of pre-authorization from insurers within time allotted for medical and therapy services being performed. Significant understanding of benefits and prior authorization as well as excellent multi-taking skills and attention to detail are paramount to complete the many aspects of this role.

Duties include, but are not limited to:

The incumbent may be asked to perform job-related tasks other than those specifically stated in this description. The duties and responsibilities of the position are to be carried out in a manner that is consistent with the Mission, Core Values and Operating Principles/Policies of CAO.

• Contribute to the achievement of excellence in health care to fulfill the mission of the unit.
• Exhibit strong and care-focused customer service skills in daily interaction with the public, patients, staff, and physicians in the performance of job duties.
• Interview patients for demographic information, evaluate eligibility, collect co-pays, deductibles, including but not limited to insurance verification.
• Contact insurance carriers to verify patient’s insurance eligibility, benefits, and requirements.
• Request, track and obtain pre-authorization from insurance carriers within time allotted for medical and Therapy services.
• Process insurance authorizations and update patient records.
• Research referrals to deny or approve based on information obtained and appropriately identify diagnosis (CPT and ICD-10 coding).
• Operate online insurance verification websites.
• Communicate any insurance changes or trends among team.
• Respond to patient inquiries and questions.
• Participate in department's Performance Improvement activities.
• Clearly document all communications and contacts with providers and personnel in standardized documentation requirements, including proper format.
• Educate patients and coworkers on preauthorization process and assist with understanding coverage information.
• Utilize computer software programs, as needed, to communicate and understand patient needs (i.e. scheduling, EMR, etc.)
• Report all necessary information and/or unusual occurrences in accordance with established policies and procedures.
• Participate in orientation programs.
• Ensures consistent compliance with all regulatory and CAO guidelines, policies, and procedures.
• Performs other duties as assigned.

Required Education & Experience

• High School Diploma or equivalent.
• 1 – 2 years of medical office experience is preferred.
• Proficient knowledge in medical terminology.
• Above average spelling and typing skills needed.
• Proficient computer software (Online insurance websites and DASH) and database skills.
• Proficiency with Microsoft Office suite of products.
• Experience collaborating across multiple functions.
• Experience innovating in a fast-growing work environment and dealing with ambiguity.
• Strong Interpersonal Skills - Ability to develop relationships and collaborate and influence…