Pre-Service Authorization Specialist

Job Summary

Working remotely in a full-time capacity, the Pre-Service Authorization Specialist will complete pre-authorizations for various healthcare services, verify insurance information, and ensure financial clearance while meeting productivity and quality standards.

Key responsibilities

• Secure pre-authorizations from insurance companies for a range of services, including office visits and diagnostic studies
• Review medical records and documentation to ensure accurate submission for authorization requests
• Communicate with healthcare providers and insurance carriers to facilitate timely authorization approvals

Required qualifications

• Minimum two years of experience in pre-authorization, referral coordination, or insurance billing within a healthcare setting
• Proficiency in medical terminology, validated by examination
• Experience reviewing medical policies and interpreting CPT and HCPCS codes
• Completion of a health vocational program (e.g., Medical Assistant, Medical Billing & Insurance) preferred
• Certification from the National Association of Healthcare Access Management (NAHAM) preferred