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Prior Authorization Representative

7/10/2025

Remote

Job Summary

A company is looking for a Prior Authorizations and Referral Management Representative.

Key Responsibilities
  • Coordinate prior authorization and referral processes for patients requiring services and testing
  • Validate patient health plan coverage and communicate necessary information to health plans
  • Facilitate scheduling of patients with various departments and maintain accurate records of authorizations and referrals


Required Qualifications, Training, and Education
  • High School diploma or GED required; college-level coursework preferred
  • Minimum of one year experience in a hospital, clinic, or medical insurance billing office
  • Basic understanding of medical coding
  • Ability to use electronic medical records systems and MS Office applications
  • Must be able to wear appropriate Personal Protective Equipment (PPE) as required

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