Pre-Authorization Specialist

Job Summary

A company is looking for a Pre-Authorization Specialist.

Key Responsibilities

• Identify prior authorization requirements by insurance/payer and process pre-authorizations for services
• Utilize third-party payer/insurance portals to ensure correct coverage and document results in Epic
• Communicate pre-authorization approvals or denials to providers and collaborate to secure necessary clinical information

Required Qualifications

• Experience in processing prior authorizations
• Knowledge of insurance providers and their authorization processes
• Ability to advocate for patients and providers in a timely manner
• Proficiency in using healthcare documentation systems
• High school diploma or equivalent; relevant certifications may be preferred