Clinical Prior Authorization Specialist

Job Summary

A company is looking for a Clinical Prior Authorization Specialist to join their Operations team.

Key Responsibilities

• Coordinate and obtain prior authorizations for medical services, tests, procedures, and medications
• Review clinical documentation to assess medical necessity and payer requirements
• Document authorization activities and communicate outcomes to providers and patients

Required Qualifications

• Minimum 2 years of experience in prior authorization, utilization management, or related healthcare fields
• Strong clinical knowledge and familiarity with payer portals, ICD-10, CPT, and HCPCS coding
• Ability to work independently and proactively as a team player
• Outstanding organizational and multitasking abilities
• Self-driven and adaptable to new technology