Prior Authorization Representative

Job Summary

A company is looking for a Prior Authorization Representative II to join their remote team.

Key Responsibilities

• Contact insurance companies for patient eligibility, benefits, and authorization
• Follow up on delayed or denied authorization requests and facilitate medical determinations
• Maintain documentation of authorization history and serve as a liaison between payers and clinic staff

Required Qualifications

• Three years of experience in a health care financial setting, or equivalent
• Six months of experience as a Prior Authorization Rep I or equivalent prior-authorization experience
• Previous experience with insurance and prior authorizations is preferred
• ICD/CPT Coding Certification is preferred
• Experience with inpatient and day surgery prior authorizations is preferred