We’re looking for a detail-oriented and experienced Prior Authorization Specialist to join our growing team. In this role, you will be responsible for handling pre-certifications, verifying insurance coverage, and ensuring timely approvals for medical procedures, medications, and services. Your work will directly support patients in accessing the care they need while ensuring compliance with payer requirements.

Key Responsibilities:

• Review prior authorization requests and submit required documentation to insurance companies.
• Verify patient eligibility and benefits.
• Communicate with providers, patients, and insurance representatives to resolve authorization issues.
• Track and follow up on pending authorizations to ensure timely approvals.
• Maintain accurate records of authorizations and denials in the system.
• Stay updated on payer policies and requirements.

Qualifications:

• Previous experience as a Prior Authorization Specialist, Medical Biller, or similar healthcare/insurance role.
• Strong knowledge of medical terminology, insurance processes, and authorization requirements.
• Excellent communication and problem-solving skills.
• High attention to detail and organizational skills.
• Ability to work efficiently in a fast-paced environment.