Pre-Authorization Specialist

A company is looking for a Pre-Authorization Specialist.

Key Responsibilities

Identify prior authorization requirements by insurance / payer and process pre-authorizations for scheduled and add-on services

Utilize third-party payer / insurance portals to submit pre-authorizations and document results accurately

Communicate pre-authorization approvals or denials to leadership and healthcare providers, advocating for patients in a timely manner

Required Qualifications

Experience with insurance providers and their authorization processes

Knowledge of Epic or similar healthcare documentation systems

Ability to analyze and interpret insurance coverage information

Experience in a healthcare setting related to pre-authorizations

Relevant certifications in healthcare administration or insurance processes may be preferred