Prior Authorization Specialist

Job Summary

A company is looking for a Prior Authorization Specialist to support the Patient Access department in managing prior authorization processes for medical services.

Key Responsibilities

• Contact payors for eligibility and benefit information, including authorization requirements
• Obtain prior authorizations and pre-certifications, and submit complete authorization requests
• Follow up on pending authorization requests and maintain documentation of authorization activity

Required Qualifications

• 2+ years of experience in healthcare administration or prior authorization processes
• Experience in reviewing and processing prior authorization requests for medical procedures and services
• 1+ years of prior authorization experience in physical therapy, occupational therapy, and/or orthopedics
• Medical Assistant Certification or 5 years of experience in a provider's office setting processing prior authorizations is preferred
• Bachelor's degree in Healthcare Administration, Business Administration, or a related field is preferred