Prior Authorization Specialist

Job Summary

To support the referral and authorization process for specialty services, the part-time Prior Authorization Specialist will manage referrals and authorizations, collaborate with clinical teams and insurance companies, and ensure timely access to care while working remotely within Massachusetts and Connecticut.

Key responsibilities:

• Process referrals and prior authorizations, ensuring accuracy and timely documentation
• Collaborate with healthcare providers and insurance companies to gather necessary information
• Monitor and address denial reports, processing appeals for denied claims as needed

Required qualifications:

• 1-3 years of medical insurance knowledge
• GED or HiSET required
• Experience with electronic medical records (EMR) preferred
• Proficiency in Microsoft Office, including Word and Excel
• Bilingual in English/Spanish preferred