Prior Authorization Specialist

Job Summary

To support the referral and authorization process for specialty services, the full-time Prior Authorization Specialist will work remotely, ensuring accurate processing of referrals, collaborating with healthcare teams, and managing documentation for timely patient care.

Key responsibilities

• Process referrals and prior authorizations for specialty services, ensuring accuracy and timely documentation
• Collaborate with clinical teams and insurance companies to gather necessary information for referrals and authorizations
• Monitor denial reports and manage appeals for denied claims while maintaining accurate documentation in patient records

Required qualifications

• 1-3 years of medical insurance knowledge
• GED or HiSET required
• Familiarity with medical terminology preferred
• Proficiency with Microsoft Office, particularly Word and Excel
• Experience with CIS inbox and EMR systems preferred