
Prior Authorization Professional
1 week ago
Prior Authorization Specialist Job Opportunity
- This is a full-time position that requires strong organizational skills and the ability to work independently.
The Prior Authorization Specialist will be primarily responsible for obtaining all types of prior authorizations, including biologic medications, procedures, prescriptions and out-patient testing. The ideal candidate will have strong knowledge of insurance verification processes and payer/billing guidelines, excellent communication and interpersonal skills to work effectively with patients, providers, and insurers.
Key Responsibilities:
- Review and process prior authorization requests for medical services, procedures, and medications
- Verify insurance information and eligibility
- Handle patient inquiries regarding authorizations
- Provide necessary documentation to patients for completion and signature. Review all forms for completeness and accuracy.
- Accurately document interactions in EMR.
- Coordinate with healthcare providers and insurance companies to obtain necessary authorizations
- Ensure accurate and timely documentation of authorization requests and approvals
- Collaborate with medical billing team to resolve any issues or denials
- Maintain up-to-date knowledge of insurance guidelines and procedures
This role requires a detail-oriented individual who can work independently and meet deadlines. Experience working in a remote setup is highly preferred.
Requirements:
- Proven experience as a Prior Authorization Specialist in the US Healthcare industry
- Strong knowledge of insurance processes and payer/billing guidelines
- Excellent communication skills to work effectively with patients, providers, and insurers
- Detail-oriented with strong organizational skills
- Ability to work independently and meet deadlines
- Comfortable working remotely
System Requirements:
- Device: Desktop or Laptop
- Processor:
- Windows Devices: Intel Core i5 (or higher) or AMD Ryzen 5 (or higher)
- Mac Devices: Apple M1 chip or newer
- Minimum: 8GB or higher for optimal performance
- Windows: Windows 11 Pro (Windows 10 Pro is acceptable but not preferred). The operating system must have a legitimate license.
- Mac: macOS compatible with M1 or newer chips
- SSD: At least an SSD for faster processing and performance
- Speed: Minimum speed of 50 Mbps via a wired connection for stability and reliability
- Backup: A backup internet connection is highly recommended
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