Remote Authorization Specialist

Job Summary

Working remotely on a full-time basis, the Remote Authorization Specialist will obtain and maintain prior authorization for patient medications and therapies while collaborating with clinical and billing departments to ensure compliance with payer requirements.

Key responsibilities:

• Obtain and maintain prior authorization status for patient medications and therapies
• Collaborate with the clinical review department to gather necessary documentation for the authorization process
• Support the billing department by providing documentation that meets payer requirements for patient accounts

Required qualifications:

• High School Diploma or equivalent required
• Minimum of 2 years of authorization, reimbursement, or claims processing experience required
• Practical experience with medical terminology, including CPT, ICD-9, and HCPC coding preferred
• Familiarity with Medicare, Medicaid, and third-party payor contracts preferred
• Knowledge of HIPAA Privacy and Security requirements preferred