pre-authorization/patient access specialist.

Randstad is seeking a detail-oriented Pre-Authorization Insurance Verification Specialist to join a hospital system. This role ensures that all patient services are authorized, verified, and financially cleared prior to service to support a smooth patient experience and reduce claim denials. The ideal candidate has hands-on experience in prior authorizations, eligibility and benefits verification, pre-surgical and outpatient pre-registration, and familiarity with commercial insurance, Medicare, and Medicaid payors.

• Mission-driven organization serving the pediatric community.
• Competitive compensation and full benefits package including health, dental, vision, paid time off, and 401(k) match.
• Collaborative and supportive work environment focused on quality and care continuity.

salary: $52,000 - $56,000 per year
shift: First
work hours: 8:30 AM - 5 PM
education: High School

Responsibilities

• Verify insurance eligibility and benefits prior to scheduled or same-day services.
• Obtain pre-certifications and authorizations for outpatient and surgical procedures, ensuring clinical documentation is complete and submitted accurately.
• Communicate with payers, providers, and patients to clarify coverage, coordinate peer-to-peer reviews, and resolve missing information or denials.
• Track and follow up on denials, revalidate coverage, and resubmit documentation as needed.
• Collaborate with financial counselors and clinical departments to ensure proper financial clearance and reduce patient delays.
• Document all verification and authorization activities in the electronic health record (EHR) or registration system.
• Support the integrity of the hospital’s revenue cycle by ensuring payor requirements are met prior to care delivery.

Skills

Insurance verification (1 year of experience is required)

Insurance eligibility (1 year of experience is required)

Prior Authorization (1 year of experience is required)

Pre-Registration

Outpatient authorization

patient access

CPT Codes

ICD-10

Insurance Claim Processing

Health Insurance Policies

Written Communication

Basic Software Skills

EHR/Epic

EMR

Qualifications

Years of experience: 1 year

Experience level: Experienced

Randstad is a world leader in matching great people with great companies. Our experienced agents will listen carefully to your employment needs and then work diligently to match your skills and qualifications to the right job and company. Whether you're looking for temporary, temporary-to-permanent or permanent opportunities, no one works harder for you than Randstad.

Equal Opportunity Employer: Race, Color, Religion, Sex, Sexual Orientation, Gender Identity, National Origin, Age, Genetic Information, Disability, Protected Veteran Status, or any other legally protected group status.

At Randstad, we welcome people of all abilities and want to ensure that our hiring and interview process meets the needs of all applicants. If you require a reasonable accommodation to make your application or interview experience a great one, please contact HRsupport@randstadusa.com.

Pay offered to a successful candidate will be based on several factors including the candidate's education, work experience, work location, specific job duties, certifications, etc. In addition, Randstad offers a comprehensive benefits package, including: medical, prescription, dental, vision, AD&D, and life insurance offerings, short-term disability, and a 401K plan (all benefits are based on eligibility).

This posting is open for thirty (30) days.