Prior Authorization Specialist

Job Summary

To support patient access services, the full-time Prior Authorization Specialist will verify insurance, obtain authorizations, and coordinate financial clearance activities remotely, ensuring compliance with healthcare delivery standards.

Key responsibilities

• Processes and prioritizes incoming prior authorization requests, authorizing specified services as per departmental guidelines
• Collaborates with providers, patients, and departments to obtain necessary information and payer permissions prior to scheduled services
• 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 experience in a high-volume data entry office, customer service call center, or healthcare administration
• Experience with insurance verification, prior authorization, and financial clearance processes
• Familiarity with Meditech and insurance payer websites is strongly preferred
• Basic computer proficiency, including Microsoft Suite applications (Excel, Word, Outlook, Zoom)