Authorization Specialist

RALEIGH MEDICAL GROUP PA • Raleigh, NC

26d • Onsite

About The Position

Raleigh Medical Group, PA, is seeking an Authorization Specialist to support timely and accurate prior authorizations for medications, diagnostic procedures, and specialty services across the organization. This role plays an important part in ensuring patients receive access to care without unnecessary delays while maintaining strong communication with patients, providers, pharmacies, and insurance companies. The Authorization Specialist works collaboratively with clinical and administrative teams to verify insurance requirements, monitor authorization status, and ensure accurate documentation within the EHR and practice management system.

Requirements

• High school diploma or equivalent required
• Minimum of 1 year of medical office and EHR experience
• Prior authorization experience required
• Strong communication, organization, and customer service skills
• Attention to detail and ability to prioritize tasks effectively
• Ability to work independently with minimal supervision

Responsibilities

• Obtain prior authorizations and pre-certifications for medications, procedures, and specialty services
• Verify insurance benefits and identify authorization requirements as needed
• Monitor authorization status and follow up to prevent delays in patient care
• Communicate with patients, providers, pharmacies, and insurance companies regarding authorization requirements and updates
• Accurately document authorization and benefit information in the EHR and practice management system
• Maintain current knowledge of payer guidelines and authorization processes
• Collaborate with clinical and front office staff to coordinate patient care efficiently
• Communicate workflow updates and payer changes to appropriate team members
• Participate in departmental meetings and training sessions
• Assist with onboarding and cross-training of team members as requested
• Maintain compliance with HIPAA regulations and safeguard Protected Health Information (PHI)
• Perform other duties as assigned

Benefits

• Group Health, Dental, and Vision coverage
• FSA and HSA options
• Generous Paid Time Off (PTO)
• 401(k) Retirement Plan with employer matching
• Company-paid Life, Short-Term and Long-Term Disability
• Competitive pay

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: High school or GED