Pre Authorization Specialist

Job Summary

Supporting reimbursement and revenue cycle activities, the full-time remote Pre Authorization Specialist II will manage benefit investigations, review payer medical policies, and ensure timely prior authorizations while maintaining accurate documentation.

Key responsibilities

• Respond to high-volume billing tasks and inquiries related to pre-authorization processes and policies
• Examine incoming orders for completeness and accuracy, and monitor the status of prior authorization requests
• Collaborate with team members to develop best practices and suggest improvements for customer service

Required qualifications

• High school diploma with 3 or more years of relevant experience
• Associate degree or higher in Healthcare Administration, Business Administration, Health Information Management, or a related field is preferred
• Experience documenting healthcare authorization activities within authorization, billing, or revenue cycle management systems
• Knowledge of medical terminology, insurance guidelines, and healthcare regulations
• Proficiency in Microsoft Office applications, including Word, Excel, and Outlook