Authorization Specialist II

Job Summary

Supporting the prior authorization request process, the full-time remote Authorization Specialist II will manage documentation, verify member insurance coverage, and assist the utilization management team to ensure timely adjudication of authorization requests.

Key responsibilities

• Aids the utilization management team by tracking and documenting authorizations and referrals in accordance with policies
• Supports the authorization review process by researching and documenting necessary medical information for clinical review
• Verifies member insurance coverage and aligns authorization with guidelines to ensure timely payment adjudication

Required qualifications

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