Authorization Research Specialist

Job Summary

A company is looking for an Authorization Research Specialist III.

Key Responsibilities

• Resolve time-sensitive authorization issues affecting claims processing
• Identify and escalate claim issues related to authorizations
• Research and resolve open authorization issues impacting claim denials and appeals

Required Qualifications

• High School diploma or GED required
• 2 - 4 years of related experience required
• 2+ years experience in healthcare authorizations, denials, or medical claims preferred
• Knowledge of Medicare and Medicaid regulations preferred
• Familiarity with medical terminology and payor compliance rules preferred