Prior Authorization Specialist

Job Description

Job Description

Description :

Precision Healthcare Specialists is seeking a detail-oriented and proactive Prior Authorization Specialist to join our Pulmonary and Sleep Lab team. This role plays a key part in ensuring timely and accurate authorization of procedures, sleep studies, and diagnostic testing. The ideal candidate will be organized, efficient, and comfortable collaborating with providers, insurance representatives, and patients to ensure a smooth authorization process that supports high-quality patient care.

Key Responsibilities :

• Obtain prior authorizations for pulmonary function tests, sleep studies, and other diagnostic or therapeutic procedures.
• Verify patient insurance coverage and eligibility before services are rendered.
• Communicate with insurance companies to submit and follow up on authorization requests.
• Work closely with providers, medical assistants, and scheduling teams to ensure all authorizations are secured before appointments.
• Maintain accurate and up-to-date documentation in the electronic medical record (EMR) system.
• Notify clinical and administrative teams promptly of authorization approvals, denials, or pending issues.
• Assist patients with understanding insurance requirements and next steps if additional information is needed.
• Stay current on payer requirements and authorization processes.

Requirements :

Why Join Precision Healthcare Specialists :