Pre-Authorization Specialist

Job Summary

To support healthcare operations, the full-time Pre-Authorization Specialist will manage prior authorization processes for scheduled and add-on services, utilizing insurance portals to ensure coverage and documenting results in Epic while communicating with providers.

Key responsibilities

• Analyze information to complete pre-authorizations based on insurance/payer requirements
• Utilize third-party payer portals to process pre-authorization submissions and document results
• Advocate for patients and providers by processing pre-authorizations in a timely manner and collaborating with clinical staff

Required qualifications

• Direct experience with insurance/payer portals
• Proficiency in documenting pre-authorization information in Epic
• Knowledge of insurance providers and their authorization approval expectations
• Experience in analyzing and resolving challenges related to pre-authorization processes
• Ability to communicate effectively with providers and clinical staff regarding authorization outcomes