Medicare Prior Authorization Specialist

Job Summary

To support Medicare coverage determination operations, the full-time Medicare Prior Authorization Specialist will manage incoming documentation, create case reviews using multiple software systems, and maintain accurate records while working remotely with rotating weekend shifts.

Key responsibilities

• Review and route incoming fax documents to appropriate work queues
• Create and maintain Medicare prior authorization case reviews while ensuring documentation accuracy
• Meet government-mandated turnaround times and productivity standards

Required qualifications

• High School Diploma or equivalent
• Minimum of 1 year of medical insurance and prior authorization experience
• Data entry experience of at least 1 year
• Ability to work in a fast-paced production environment
• Experience using multiple software applications simultaneously