Medical Insurance & Financial Specialist

Position Overview:

We are a world-renowned gynecologic surgical practice located in Sandy Springs, near Northside Hospital. We are seeking a detail-oriented and patient-focused professional to assist with insurance authorizations, provide patients with surgical cost estimates, and guide them through their financial responsibilities prior to surgery.

The ideal candidate is highly organized, thrives in a fast-paced environment, and is comfortable discussing financial matters with patients in a professional and compassionate manner. This is an in-office position and is not eligible for remote work.

Key Responsibilities:

• Submit and track prior authorization requests for all patients on the surgical schedule, ensuring approvals are obtained prior to surgery.
• Obtain retroactive authorizations when necessary.
• Prioritize workload based on authorization timelines, payer requirements, and clinical urgency, including urgent (STAT) requests.
• Prepare and present surgical cost sheets to each patient based on the recommended surgical plan.
• Communicate insurance coverage and financial responsibility clearly, addressing patient questions regarding billing, estimates, and financial assistance.
• Review and verify patient demographics and insurance information for accuracy.
• Document all communication with patients and insurance companies while maintaining accurate, up-to-date records.
• Apply office policies related to deposits, cancellations, and appointment fees when assisting patients.
• Communicate effectively with physicians, patients, coworkers, and hospital contacts.
• Update patient accounts when insurance status changes and ensure all records are updated accordingly.
• Follow up on outstanding or unresolved insurance-related matters.
• Assist with incoming calls when front desk lines are busy and provide cross-coverage as needed.

Professional Requirements:

• Minimum of 2 years of experience in a medical office setting (specialty surgery experience preferred).
• Bilingual (English/Spanish) preferred.
• Strong working knowledge of insurance plans, including commercial and marketplace plans, out-of-network benefits, retroactive authorizations, and basic CPT/ICD-10 coding.
• Ability to clearly explain insurance benefits and coverage details to patients.
• Demonstrated experience with prior authorizations is required.
• Ability to thrive in a fast-paced, high-volume surgical practice while maintaining accuracy, organization, and exceptional patient service.
• Comfortable discussing financial responsibility and surgical costs with patients in a professional and compassionate manner.

Required Skills:

• Proficiency in Microsoft Word, Excel, Outlook, and Adobe; strong general computer skills required.
• Ability to manage a high-volume workload while maintaining strong attention to detail.
• Experience with EHR/Practice Management systems.
• Strong organizational skills with excellent follow-through and time management.
• Exceptional verbal and written communication skills; must be professional, empathetic, and patient-focused.
• High level of integrity with the ability to handle confidential information in compliance with HIPAA regulations.

Compensation & Benefits:

• Employer-paid medical and dental insurance (employee-only; eligible after 3 months).
• 401(k) profit-sharing plan; eligibility after 1 year.
• Generous paid time off (PTO) that increases with tenure.
• Paid holidays.
• Generous annual Christmas bonus.

Work Schedule:

• Monday & Friday: 7:00 AM - 3:30 PM
• Tuesday l Thursday: 9:00 AM - 5:30 PM.
• No weekends required.
• This is an in-office position . Remote work is not available.