Prior Authorization Representative

Job Summary

Working remotely full-time, the Prior Authorization Representative will manage the financial clearance process by obtaining necessary authorizations and ensuring accurate patient data entry, while providing exceptional customer service and maintaining positive relationships with healthcare providers and insurance companies.

Key responsibilities

• Facilitate patient entrance processes, including insurance validation, benefit verification, and financial clearance
• Ensure accuracy of authorization details in patient records and resolve any discrepancies through critical thinking
• Communicate professionally with provider offices, insurance companies, and patients to secure and validate authorization information

Required qualifications

• High School Diploma or GED
• 2-5 years of relevant experience in prior authorization or healthcare settings
• Knowledge of insurance verification processes and Medicare guidelines
• Ability to work in a safety-sensitive environment with a constant state of alertness
• Experience with EPIC or similar healthcare software preferred