Pre-Authorization Specialist

Job Summary

A company is looking for a Pre-Authorization Specialist II responsible for benefit verification, prior authorization, and appeal functions within the Patient Access Support Program.

Key Responsibilities

• Verify medical insurance benefits and coverage, process payer forms, and submit prior authorization requests
• Follow up on prior authorization and appeal requests, ensuring proper review for medical necessity
• Provide superior customer service through incoming calls and manage inquiries via email and fax queues

Required Qualifications

• High school diploma
• Minimum 2 years of relevant experience with various payers, including Medicare and Medicaid
• Experience in submitting prior authorization requests for medical procedures
• Proficient in Microsoft Office
• Ability to work independently with minimal supervision