Senior Prior Authorization Specialist

Job Summary

Promoting an excellent patient experience, the full-time remote Senior Prior Authorization Specialist will manage prior authorizations by reviewing insurance benefits, securing necessary approvals for services, and appealing any denials to ensure payment and minimize out-of-pocket costs for patients and families.

Key responsibilities

• Review and secure authorizations for services performed prior to patient admissions
• Appeal pre-service authorization and claim denials related to prior authorizations
• Interpret payor requirements and maintain effective communication with providers, patients, and families

Required qualifications

• High School Diploma or GED; post-secondary education in a related field preferred
• Three years of experience in a healthcare or related field, with preferred experience in medical billing or prior authorization
• Knowledge of governmental and commercial payors and medical billing requirements
• Ability to work effectively in a remote environment and connect via multiple communication channels
• Proficient in Microsoft Office applications