Prior Authorization Specialist
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Job Summary
Detail-oriented and experienced, the full-time Prior Authorization Specialist will obtain and verify prior authorizations for procedures and diagnostic tests in a fully remote capacity, ensuring compliance with insurance policies and healthcare regulations.
Key responsibilities
- Ensure timely and accurate insurance authorizations are obtained prior to services being rendered
- Verify insurance eligibility and benefit levels for adequate coverage of services
- Collaborate with healthcare providers, patients, and insurance representatives to facilitate the authorization process
Required qualifications
- Associate's degree in healthcare administration or business administration preferred
- 3-5 years of experience in a similar role or related field in a healthcare setting
- Familiarity with medical office procedures and billing practices
- Experience with Athena software required
- Proficient in clinical documentation review for insurance authorization alignment
Complete Job Description
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