Prior Authorization Specialist

Job Summary

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

Key responsibilities

• Prioritizes and processes incoming prior authorization requests, authorizing specified services as per departmental policies
• Collaborates with clinicians and other stakeholders to obtain necessary information and ensure timely access to care
• Maintains knowledge of insurance requirements and navigates payer policies to facilitate financial clearance for scheduled services

Required qualifications

• High school diploma or GED required; Associate's Degree or higher preferred
• 4-5 years of office experience in a high-volume data entry, customer service call center, or healthcare setting
• Experience with insurance verification, prior authorization, and financial clearance processes
• Familiarity with insurance payer websites and basic medical terminology is helpful
• Bilingual candidates are preferred