Prior Authorization Specialist

Job Summary

Owning the authorization lifecycle, the full-time Patient Call Agent - Prior Authorization will submit requests, track resolutions, and manage payer follow-ups while working remotely on a fixed schedule from 9 PM to 6 AM PHT.

Key responsibilities

• Submit and track authorization requests through payer portals, ensuring all necessary clinical documentation is collected and validated
• Assist healthcare professionals and insurance members with authorization-related inquiries, providing clear explanations of billing and benefits
• Manage a high-volume workload while maintaining accurate documentation and adhering to HIPAA regulations

Required qualifications

• Previous experience in prior authorization within a healthcare BPO, hospital, clinic, or revenue cycle department
• Familiarity with EHR/EMR systems and payer portals
• Ability to manage multiple queues and prioritize tasks effectively
• Strong organizational skills and attention to detail in documentation
• Completion of required HIPAA and security training