Prior Authorization Specialist

Job Summary

A company is looking for a Prior Authorization Specialist I.

Key Responsibilities

• Screen and process prior authorization requests for medical services according to departmental guidelines
• Coordinate financial clearance activities, including obtaining necessary insurance verifications and referrals
• Collaborate with patients, providers, and departments to ensure timely access to care and proper documentation of authorizations

Required Qualifications

• High school diploma or GED required; Associate's Degree or higher preferred
• 4-5 years of office experience in a high-volume data entry, customer service call center, or healthcare setting
• Experience with insurance verification, prior authorization, and financial clearance processes
• Knowledge of medical terminology and familiarity with insurance payer websites
• Bilingual preferred