Prior Authorization Specialist

Job Summary

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

Key responsibilities

• Prioritizes and processes incoming prior authorization requests, authorizing specified services as per departmental policies
• Collaborates with patients, providers, and departments to gather necessary information for financial clearance and resolves escalated inquiries
• Maintains knowledge of insurance requirements and ensures timely access to care while maximizing hospital reimbursement

Required qualifications

• High school diploma or GED required; Associate's Degree or higher preferred
• 4-5 years of office experience, preferably in healthcare administration or customer service
• Experience with insurance verification, prior authorization, and financial clearance processes
• Familiarity with insurance payer websites and basic medical terminology
• Bilingual candidates are preferred