Prior Authorization Analyst

Job Summary

A company is looking for a Prior Authorization Rules Analyst.

Key Responsibilities

• Analyze payer policy documents and manage the loading of related requirements for Prior Authorization
• Oversee the work queue for an offshore team and contribute to internal and external education on payer authorization requirements
• Collaborate with the product team to define and prioritize functionality related to payer ruleset

Required Qualifications

• Bachelor's degree or equivalent work experience
• 3+ years of experience with Prior Authorizations and payer authorization requirements
• Clinical knowledge relevant to Correct Coding guidelines (NCCI)
• Experience interfacing with partner organizations and healthcare software related to Prior Authorizations
• Ability to work independently and manage multiple projects in a fast-paced environment