Pre-Authorization Specialist

Job Summary

To support efficient patient care, the full-time Pre-Authorization Specialist will identify prior authorization requirements, process submissions through insurance portals, and communicate approvals or denials to healthcare providers while working remotely during day shifts from 8 AM to 5 PM.

Key responsibilities

• Analyze and complete pre-authorizations based on various insurance requirements and document results in Epic
• Utilize third-party payer portals proficiently to ensure timely processing of pre-auth submissions
• Advocate for patients by collaborating with healthcare providers to secure necessary clinical information for submissions

Required qualifications

• Direct experience with pre-authorization portals for insurance/payers
• Proficient knowledge of insurance providers and their authorization processes
• Ability to document and communicate pre-authorization outcomes effectively
• Experience in a healthcare support role, particularly in pre-authorization tasks
• Familiarity with Epic or similar electronic health record systems