Pre-Service Authorization Specialist

Job Summary

To ensure financial clearance for healthcare services, the full-time Pre-Service Authorization Specialist will manage pre-authorization processes, verify insurance information, and communicate with healthcare providers and insurance carriers while working remotely.

Key responsibilities:

• Secure pre-authorizations for various healthcare services and respond to clinical inquiries through insurance portals
• Review medical records and documentation to ensure accurate submissions for ordered services
• Maintain productivity standards while serving as a subject matter expert on referrals and authorizations

Required qualifications:

• Minimum two (2) years of experience in pre-authorization, referral coordination, or insurance billing in a healthcare setting
• Customer service experience in healthcare
• Proficiency in medical terminology, validated by examination
• Experience interpreting CPT and HCPCS codes in alignment with payer guidelines
• Completion of a health vocational program (e.g., Medical Assistant, Medical Billing & Insurance) preferred