Prior Authorizations Specialist

Job Summary

Working remotely in a full-time capacity, the Prior Authorizations Specialist will manage the process of obtaining pre-certifications and pre-authorizations for procedures and medications while coordinating patient appointments and ensuring compliance with insurance requirements.

Key responsibilities

• Obtain timely prior authorizations from various insurance plans, including commercial and government programs
• Verify patient demographics and insurance information while selecting pertinent medical records from the client's EMR
• Document all prior authorization follow-ups and determinations accurately and in a timely manner within company software or the client's EMR

Required qualifications

• High School Diploma or GED
• At least 5 years of experience in processing prior authorizations
• A minimum of 2 years of experience communicating with insurance companies via phone
• Familiarity with medical terminology
• Basic computer literacy and strong teamwork capabilities