Prior Authorization Specialist

Job Summary

A company is looking for a Prior Authorization Specialist to manage authorization requests and ensure compliance with healthcare regulations.

Key Responsibilities

• Determine authorization requirements for outpatient diagnostic and surgical services
• Submit authorization requests and gather necessary clinical data for insurance approvals
• Follow up with physician offices and patients to ensure compliance with medical necessity checks

Required Qualifications

• High School Diploma or GED equivalent
• Healthcare experience and familiarity with medical terminology
• Knowledge of prior authorization processes and revenue cycle
• Basic computer skills and familiarity with insurance carrier websites
• Ability to work effectively in a remote environment