Prior Authorization Specialist

Job Summary

A company is looking for a Prior Authorization Representative to verify and obtain prior authorization for patient therapies.

Key Responsibilities

• Validate insurance coverage and communicate any issues to management
• Check and initiate prior authorization requirements as needed
• Coordinate and submit necessary paperwork and follow up on authorization status

Required Qualifications

• Basic knowledge of payer payment processes and prior authorization procedures
• Familiarity with ICD9/10 and CPT codes, particularly therapy codes
• Advanced skills in Microsoft Excel and ability to learn CRM software
• Strong organizational skills to manage multiple inquiries simultaneously
• Experience in customer service and interaction with various stakeholders