Prior Authorization Specialist

Job Summary

Supporting the Patient Access Onshore department, the full-time remote Prior Authorization Specialist will manage insurance verification and coordinate prior authorization requests for medical services, ensuring timely patient access to healthcare.

Key responsibilities:

• Contact payers for eligibility and benefit information, including authorization requirements
• Obtain prior authorizations and pre-certifications, submitting complete and accurate requests
• Follow up on pending authorization requests and maintain documentation of authorization activity

Required qualifications:

• High School Diploma or equivalent
• 2+ years of experience in prior authorization and insurance eligibility/benefits verification
• Experience with verifying coverage, deductibles, copays, and authorization requirements
• Familiarity with medical terminology, CPT/ICD-10 codes, and payer portals
• Experience resolving authorization denials and supporting appeals preferred