Healthcare Pre-authorization Representative

Job Summary

A company is looking for a Healthcare Pre-authorization Representative.

Key Responsibilities

• Manage authorizations, notifications, and service requests via phone calls, faxes, and portal submissions
• Provide excellent customer service and handle escalated calls effectively
• Coordinate with Medical Directors and clinical staff for authorization cases and maintain production and quality standards

Required Qualifications

• High School Diploma / GED (or higher)
• 2+ years of experience in healthcare, call center, or customer service settings
• Proficiency in Microsoft Office (Word, Excel, Outlook) and knowledge of Medical Terminology
• Familiarity with ICD-9/ICD-10 and CPT coding
• Ability to work varying shifts to support 24/7 operations