Prior Authorization Specialist

Job Summary

To support the financial clearance process, the part-time Prior Authorization Specialist will screen prior authorization requests, coordinate specialized services, and ensure compliance with healthcare delivery standards while working remotely.

Key responsibilities

• Prioritize and process incoming prior authorization requests, authorizing specified services as per departmental guidelines
• Collaborate with clinicians and other stakeholders to obtain necessary referrals and authorizations for patient services
• Maintain accurate records of patient and insurance information, ensuring timely access to care and adherence to quality assurance standards

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, customer service, or healthcare office environment
• Experience with insurance verification, prior authorization, and financial clearance processes
• Knowledge of medical terminology and familiarity with insurance payer websites
• Bilingual candidates are preferred