Medical Authorization Specialist

Job Summary

Detail-oriented and experienced, the fully remote Medical Authorization Specialist will manage prior authorizations for medically necessary surgical procedures, review clinical documentation for payer compliance, and ensure timely patient care without unnecessary delays or denials.

Key responsibilities

• Submit and manage prior authorization requests for surgical and procedural services
• Review patient charts and supporting documentation to ensure medical necessity requirements are met
• Communicate with insurance companies, providers, and internal departments to resolve authorization-related issues

Required qualifications

• High school diploma or equivalent required
• 1-2+ years of prior authorization experience in a healthcare revenue cycle environment required
• Strong understanding of medical prior authorizations and payer guidelines
• Experience working with insurance portals and surgical authorizations
• Prior experience with vascular, surgical, or specialty procedure authorizations strongly preferred