Authorization Specialist

A company is looking for an Authorization Specialist I responsible for obtaining medical necessity approvals and verifying insurance criteria for patient services.

Key Responsibilities

Review medical charts and physician orders to determine appropriate coding and medical necessity

Submit and manage authorization requests while ensuring compliance with payer guidelines

Facilitate denial mitigation steps and communicate effectively with care teams and patients

Required Qualifications

A.A. / A.S. in business, healthcare, or related area, or 3 years of revenue cycle experience in lieu of a degree

1 year of experience in revenue cycle, insurance verification, or related fields using EHR or enterprise software

Knowledge of insurance terminology, plan types, and approval processes

Proficiency in computer systems, including Microsoft Office 365