Authorization Specialist II

Job Summary

Supporting the prior authorization request process, the full-time remote Authorization Specialist II will assist the utilization management team by documenting authorization requests, verifying member insurance coverage, and maintaining accurate records for behavioral health services.

Key responsibilities

• Aids the utilization management team in tracking and documenting authorizations and referrals according to policies and guidelines
• Researches and documents necessary medical information for the authorization review process to assist clinical reviewers
• Verifies member insurance coverage and ensures timely adjudication of authorization requests

Required qualifications

• High School diploma or GED
• 1 - 2 years of related experience in healthcare or insurance
• Knowledge of medical terminology and insurance processes preferred