Prior Authorization Specialist

Job Summary

To support the financial clearance process, the full-time Prior Authorization Specialist will manage incoming prior authorization requests, authorize specified services under supervision, and ensure compliance with departmental guidelines while working remotely.

Key responsibilities

• Prioritizes and processes incoming prior authorization requests, ensuring timely access to care
• Collaborates with providers and patients to obtain necessary information and payer permissions for scheduled services
• Maintains knowledge of insurance requirements and assists in navigating the financial clearance process

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
• Strong knowledge of medical terminology and familiarity with ICD-9/CPT coding preferred
• Bilingual candidates are preferred