Authorization Specialist

Job Summary

A company is looking for an Authorization Specialist to join their Care Delivery team.

Key Responsibilities:

• Manage a team to evaluate intake applications for program eligibility and ensure documentation is submitted to MCOs
• Review medical records for timely prior authorizations to avoid delays in care
• Collaborate with partners to enhance customer satisfaction and compliance, managing prior authorization processes efficiently

Required Qualifications:

• High School diploma or equivalent with two years of prior authorization experience
• Strong understanding of medical terminology
• Proficiency in Microsoft Office applications
• Ability to analyze data and exercise independent judgment
• Familiarity with MCO regulations for Pennsylvania home health aide (HHA) services is preferred