Medical Authorization Specialist

Job Summary

Detail-oriented and experienced, the fully remote Medical Authorization Specialist will manage prior authorizations for surgical procedures, review clinical documentation for payer compliance, and ensure timely patient care in a high-volume healthcare environment.

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 medical or healthcare revenue cycle environment required
• Strong understanding of medical prior authorizations and payer guidelines
• Experience working with insurance portals and authorization workflows required
• Prior experience with surgical authorizations strongly preferred