Pre-authorization Representative

Job Summary

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

Key Responsibilities

• Manage authorizations and notifications received via phone calls, faxes, and portal submissions
• Provide excellent customer service, including handling escalated callers and confirming member eligibility
• Coordinate Network Operations processes and prepare authorization cases for Medical Directors and Case Managers

Required Qualifications

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