Prior Authorization Specialist

Job Summary

To support the financial clearance process, the part-time Prior Authorization Specialist will manage prior authorization requests, coordinate services, and ensure compliance with departmental guidelines while working remotely.

Key responsibilities

• Processes incoming prior authorization requests and authorizes specified services according to departmental policies
• Collaborates with patients, providers, and departments to obtain necessary information and payer permissions prior to scheduled services
• Maintains knowledge of insurance requirements for prior authorizations and assists in navigating payer policies for approvals

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
• Familiarity with insurance payer websites and basic medical terminology; knowledge of ICD-9/CPT coding is helpful
• Bilingual candidates are preferred