Prior Authorization Specialist

Job Summary

A company is looking for a Prior Authorization Specialist to manage the prior authorization process and support reimbursement efforts.

Key Responsibilities

• Review and resolve prior authorization inquiries and appeals
• Prepare and submit appeals to insurance companies, ensuring all documentation is complete
• Collaborate with clinical teams and insurance representatives to resolve authorization issues

Required Qualifications

• 3-5 years of experience in healthcare billing, focusing on prior authorizations and appeals
• Strong understanding of insurance policies and medical terminology
• Familiarity with insurance authorization and verification processes
• Experience with CRM applications, including SalesForce
• Knowledge of HIPAA regulations in healthcare