Prior Authorization Specialist

Job Summary

Supporting the Patient Access Onshore department, the full-time remote Prior Authorization Specialist will manage prior authorization processes, including insurance verification, contacting payors, and tracking authorization status to ensure timely patient access to healthcare.

Key responsibilities:

• Contact payors for eligibility and benefit information, including authorization requirements
• Obtain prior authorizations and pre-certifications, submitting complete and accurate requests
• Follow up on pending authorization requests and maintain documentation of authorization activity

Required qualifications:

• 2+ years of experience in healthcare administration or prior authorization processes
• Experience reviewing and processing prior authorization requests for medical procedures and services
• Ability to collaborate with healthcare providers and payers to resolve prior authorization issues
• Medical Assistant Certification or 5 years of experience in a provider's office setting is preferred