Prior Authorization Representative

Job Summary

To support patient care coordination, the part-time Prior Authorization Representative will manage prior authorization and referral processes, ensuring accurate communication with health plans and facilitating scheduling with various departments in a hybrid remote environment.

Key responsibilities

• Coordinate prior authorization and referral processes for patients seeking services and specialty care
• Validate patient health plan coverage and communicate necessary information to health plans for authorization
• Facilitate scheduling of patient appointments with internal and external departments and track authorization requests

Required qualifications

• High School diploma or GED
• Minimum of one year experience in a hospital, clinic, or medical insurance billing office
• Basic understanding of medical coding
• Experience with electronic medical records systems and MS Office applications
• Strong organizational and communication skills