Prior Authorization Specialist

Job Summary

A company is looking for a Prior Authorization Specialist I.

Key Responsibilities

• Prioritizes and processes incoming prior authorization requests, including authorizing specified services
• Coordinates financial clearance activities, ensuring timely access to care while maximizing hospital reimbursement
• Collaborates with patients, providers, and departments to obtain necessary information and payer permissions prior to scheduled services

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
• Bilingual preferred; familiarity with medical terminology and ICD-9/CPT coding is helpful
• Basic computer proficiency, including Microsoft Suite applications and experience with Epic preferred