Prior Authorization Specialist

Job Summary

A company is looking for a Prior Authorization Specialist to manage insurance approvals for healthcare services.

Key Responsibilities

• Validate insurance eligibility and benefits for services prior to patient appointments
• Identify and initiate prior authorizations for required services and track their status
• Collaborate with internal teams to ensure compliance with payer-specific authorization rules and maintain authorization logs

Required Qualifications

• High school diploma or GED required; Associate's or Bachelor's degree in a related field preferred
• 2-3 years of experience in healthcare provider services or prior authorization in a multi-payer environment
• Strong knowledge of insurance eligibility, authorizations, and payer policies
• Experience with various payer types, including Medicaid MCOs and commercial insurers
• Experience in a behavioral health or women's health setting is a plus