Prior Authorization Specialist

A company is looking for a Prior Authorization Specialist to manage insurance approvals for healthcare services.

Key Responsibilities

Validate insurance eligibility and benefits for services prior to patient appointments

Identify and initiate prior authorizations for required services and track their status

Collaborate with internal teams to ensure compliance with payer-specific authorization rules and maintain authorization logs

Required Qualifications

High school diploma or GED required; Associate's or Bachelor's degree in a related field preferred

2-3 years of experience in healthcare provider services or prior authorization in a multi-payer environment

Strong knowledge of insurance eligibility, authorizations, and payer policies

Experience with various payer types, including Medicaid MCOs and commercial insurers

Experience in a behavioral health or women's health setting is a plus