Insurance verification representative vs authorization specialist

The differences between insurance verification representatives and authorization specialists can be seen in a few details. Each job has different responsibilities and duties. It typically takes 2-4 years to become both an insurance verification representative and an authorization specialist. Additionally, an authorization specialist has an average salary of $36,518, which is higher than the $32,706 average annual salary of an insurance verification representative.

The top three skills for an insurance verification representative include patients, insurance verification and customer service. The most important skills for an authorization specialist are patients, customer service, and insurance verification.

Insurance verification representative vs authorization specialist overview

	Insurance Verification Representative	Authorization Specialist
Yearly salary	$32,706	$36,518
Hourly rate	$15.72	$17.56
Growth rate	-4%	-4%
Number of jobs	150,260	71,831
Job satisfaction	-	-
Most common degree	Bachelor's Degree, 28%	Bachelor's Degree, 33%
Average age	40	40
Years of experience	4	4

What does an insurance verification representative do?

An insurance verification representative is responsible for ensuring the coverage of a patient's healthcare benefits by required procedures. Your duties will typically include updating patient information, verifying insurance coverage of patients, and arranging payment for medical services that are not covered under insurance. In addition, you will be checking eligibility and benefits for healthcare providers and explaining Medicare and CMS guidelines as needed. As an insurance verification representative, you are also expected to advise and discuss various financing options that best fit a patient's budget.

What does an authorization specialist do?

An authorization specialist is responsible for reviewing insurance claims and determining the necessary settlement for the clients and involved parties. Authorization specialists file documents and gather the required information for further investigation and analysis. They coordinate with the insurance agency and the medical institution and ensure that the correct communications are being sent out for reference. An authorization specialist must have excellent communication and organizational skills, especially in writing authorization requests and resolve claims timely and efficiently.

Insurance verification representative vs authorization specialist salary

Insurance verification representatives and authorization specialists have different pay scales, as shown below.

	Insurance Verification Representative	Authorization Specialist
Average salary	$32,706	$36,518
Salary range	Between $28,000 And $37,000	Between $28,000 And $47,000
Highest paying City	Charleston, WV	Milford, MA
Highest paying state	Massachusetts	Massachusetts
Best paying company	Student Conservation Association	Guidehouse
Best paying industry	Health Care	Health Care

Differences between insurance verification representative and authorization specialist education

There are a few differences between an insurance verification representative and an authorization specialist in terms of educational background:

	Insurance Verification Representative	Authorization Specialist
Most common degree	Bachelor's Degree, 28%	Bachelor's Degree, 33%
Most common major	Business	Business
Most common college	Stanford University	University of Pennsylvania

Insurance verification representative vs authorization specialist demographics

Here are the differences between insurance verification representatives' and authorization specialists' demographics:

	Insurance Verification Representative	Authorization Specialist
Average age	40	40
Gender ratio	Male, 15.1% Female, 84.9%	Male, 15.4% Female, 84.6%
Race ratio	Black or African American, 12.6% Unknown, 4.8% Hispanic or Latino, 22.0% Asian, 6.3% White, 53.8% American Indian and Alaska Native, 0.6%	Black or African American, 10.8% Unknown, 5.5% Hispanic or Latino, 22.6% Asian, 6.9% White, 53.6% American Indian and Alaska Native, 0.8%
LGBT Percentage	7%	7%

Differences between insurance verification representative and authorization specialist duties and responsibilities

Insurance verification representative example responsibilities.

Coach, evaluate and performance manage MSRs to ensure timely and accurate service to clients.
Practice confidentiality while handling patients' medical information with use of the HIPAA law.
Verify Medicare, Medicaid, other government agencies and private insurance for new patients to determine their individualize eligibility and benefits.
Verify HMO referrals and treatment plans are authorize.
Have knowledge in difference between HMO and PPO insurance.
Comply with HIPPA due to the nature of client information.

Authorization specialist example responsibilities.

Demonstrate knowledge of HIPAA by appropriately managing patient confidentiality.
Utilize CMS and InterQual criteria to establish authorizations for members requiring medical services for a Medicare advantage insurance company.
Build authorization, match ICD-10 codes with there procedure codes
Provide patients with patient registration forms in order to follow up on patient check-in and check-out utilizing a proprietary management system.
Obtain verification of insurance coverage and authorizations for clinical visits and surgical procedures for patients.
Perform all components of the office registration including arrival, check-in and future appointments.

Insurance verification representative vs authorization specialist skills

Common insurance verification representative skills

Patients, 21%
Insurance Verification, 14%
Customer Service, 11%
Medical Terminology, 6%
Insurance Benefits, 4%
Insurance Eligibility, 4%

Common authorization specialist skills

Patients, 20%
Customer Service, 10%
Insurance Verification, 6%
Medical Terminology, 6%
Insurance Eligibility, 4%
Veterans, 4%

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Insurance Verification Representative
Insurance Verification Representative vs Authorization Specialist

Updated January 8, 2025

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