Prior Authorization Specialist

Job Summary

A company is looking for a Prior Authorization Specialist - Health Systems/Post-Acute.

Key Responsibilities

• Review and verify insurance information and patient eligibility for prior authorizations
• Communicate with hospital teams and providers to gather required documentation and submit prior authorization requests
• Monitor and track authorization requests to ensure timely processing and follow-up

Required Qualifications

• 4+ years of prior authorization experience in hospital-based and/or post-acute care settings
• Hands-on experience working in Epic
• Experience across multiple specialties is a plus
• Familiarity with major payors such as UnitedHealthcare, Aetna, and BCBS
• Strong understanding of complex care transitions and authorization nuances