Prior Authorization Specialist

Job Summary

To support patient care initiatives, the full-time Prior Authorization Specialist will collaborate with insurers to obtain pre-authorizations for medical procedures and medications, manage documentation, and communicate with patients and healthcare providers to navigate insurance processes.

Key responsibilities

• Submit prior authorization requests and gather necessary clinical documentation to support these requests
• Communicate with insurance representatives to clarify requirements and resolve authorization denials
• Maintain accurate records of prior authorization requests and stay updated on relevant insurance policies and regulations

Required qualifications

• Minimum of 2 years' experience in EPIC EMR/EHR
• At least 2 years of prior authorization experience within a healthcare setting
• Understanding of healthcare insurance systems
• Strong ability to explain complex medical and insurance information
• Proficiency in Microsoft Office applications, including Word and Excel