Prior Authorization Representative

Job Summary

To support a growing medical billing team, the full-time Prior Authorization Representative II will manage insurance verification, obtain benefit information, and secure prior authorizations remotely while collaborating with healthcare providers and clinic staff.

Key responsibilities:

• Contact insurance companies for patient eligibility, benefits, and authorization
• Follow up on delayed or denied authorization requests and facilitate medical determinations
• Maintain accurate documentation of authorization history and resolve claims denials as needed

Required qualifications:

• Three years of experience in a healthcare financial setting or equivalent
• Six months of experience as a Prior Authorization Representative I or equivalent
• Familiarity with ICD and CPT coding
• Experience with inpatient and day surgery prior authorizations is preferred
• Ability to work during UMB office hours, Monday to Friday, 8am to 5pm Mountain Time