Prior Authorization Specialist

Job Summary

Working remotely in a full-time capacity, the Prior Authorization Assistant will process prior authorizations, serve as a resource for team members, and collaborate with leadership to enhance workflows through AI technology.

Key responsibilities

• Review and verify insurance information and patient eligibility for prior authorizations
• Communicate with healthcare providers to gather necessary medical documentation
• Submit and monitor prior authorization requests to ensure timely processing and resolution

Required qualifications

• 4+ years of experience with prior authorization
• Experience in multiple specialties such as Oncology/Hematology, Cardiology, and Physical Therapy
• Familiarity with athenahealth and/or NextGen systems
• Knowledge of major payors including UnitedHealthcare, Aetna, and Blue Cross Blue Shield
• Experience in hands-on leadership roles is a plus