Pre-Authorization Specialist

Job Summary

To support patient care, the full-time Pre-Authorization Specialist will identify prior authorization requirements, process and complete prior authorizations for services, and communicate with providers regarding approvals or denials, all while working remotely during standard day shifts.

Key responsibilities

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

Required qualifications

• High school diploma or GED
• Experience with direct pre-authorization portal usage
• Basic computer skills, including proficiency with word processing, spreadsheets, and email applications
• Ability to maintain confidentiality and communicate professionally with diverse individuals
• Basic reading, writing, and oral skills in English