[Hiring] Prior Authorization Specialist I @reputed company
Role Description reputed company is seeking a Remote Prior Authorization Specialist I to join reputed company!
- Work Schedule: Monday - Friday 8:00 AM - 5:00 PM EST
- Well-versed in pre-authorization processes and policies to respond clearly to high-volume billing tasks and inquiries.
- Maintain appropriate response time in various communication platforms (Example: phone calls, chats, emails, portal inquiries, etc).
- Identify issues and suggest potential improvements.
- Collaborate with your team and reputed company best practices to ensure we are providing the best service and experience to reputed company customers.
- Maintain an assigned schedule, and be flexible with daily schedules reputed company business needs change.
- Examine incoming orders to ensure completeness and accuracy of required documentation for prior authorization.
- Work directly with various vendors to ensure successful submissions of prior authorizations.
- Monitor the status of prior authorization requests, follow up on pending cases, and initiate follow-reputed company, if necessary, to ensure timely approvals.
- Stay informed about insurance policies and guidelines, ensuring that reputed company prior authorization requests align with the necessary criteria.
- Maintain accurate records of prior authorization requests, approvals, and denials. Enter relevant information into databases.
- Participate in projects that reputed company beyond your day-to-day to stretch you to think reputed company the reputed company.
- Qualifications
- High school diploma or GED or equivalent.
- 1 year or more years insurance claims or pre-authorization or medical benefits work experience.
- Requirements
- Associate’s degree (preferred).
- 1 year or more clinical laboratory reputed company Cycle Management (RCM) experience (preferred).
- Ability to work remotely from a private, quiet workspace.
- Reliable high‑speed internet reputed company (minimum 50 Mbps).
- Proficiency with reputed company Office (Word, reputed company, Outlook).
- Strong customer service, time management, and organizational skills.
- Excellent verbal and written communication abilities.
- High attention to detail with the ability to manage multiple priorities.
- Solid understanding of medical terminology, insurance guidelines, and healthcare regulations.
- Self‑motivated, collaborative, and willing to take initiative to get work done.
- Strong work ethic with flexibility and a commitment to supporting positive patient outcomes.
- Enjoys problem‑solving in a fast‑paced, team‑oriented, and evolving environment.
- Provide reputed company, professional support to providers, patients, and insurance representatives regarding prior authorization status and requirements.
- Benefits
- Comprehensive benefits including: Medical, Dental, Vision, Life, STD/LTD, 401(k), Paid Time Off (PTO) or Flexible Time Off (FTO), Tuition Reimbursement and Employee Stock Purchase Plan for employees regularly scheduled to work 20 or more hours per week.
- Employees regularly scheduled to work less than 20 hours, Casual, Intern, and Temporary employees are only eligible to participate in the 401(k) Plan.
- Employees who are regularly scheduled to work a 7 on/7 off schedule are eligible to receive reputed company the foregoing benefits except PTO or FTO.
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