Authorization Specialist - Per Diem
About The Position
The Per Diem Float Pool Authorization Specialist is a highly adaptable, professional responsible for securing timely prior authorizations for surgical procedures, durable medical equipment (DME), and medications across various outpatient ambulatory clinics within UNLV Health. This role acts as a critical link between clinic practitioners, insurance payers, and patients, mitigating financial risk, preventing delays in patient care, and ensuring administrative continuity. The specialist deploys to diverse clinical specialties on an as-needed basis to accelerate the approval process using advanced healthcare portals and ensures strict, standardized documentation compliance within the Epic EMR system. Candidates must be legally authorized to work in the United States. UNLV Health does not provide employment sponsorships or sponsorship transfers for any positions.
Requirements
- Must be legally authorized to work in the United States.
- Two years of direct experience managing prior authorizations in an outpatient ambulatory care setting or medical billing environment.
- Must be Bilingual English/Spanish
- Knowledge of health plans, eligibility and guidelines
- Demonstrated ability to read, write and speak English
- Demonstrated ability to use a computer
- Minimum typing speed of 35 wpm
- Minimum 1 year of hands-on experience utilizing Epic EMR (specifically Epic Cadence/Prelude or Referral standard workflows).
Nice To Haves
- Associate degree or healthcare administration coursework preferred.
- Experience floating or working across multiple specialties is highly desirable.
Responsibilities
- Initiate, track, and secure prior authorizations for complex surgical procedures, high-cost DME, and specialty/retail medications across varied clinical environments.
- Utilize online insurance portals (e.g., Availity, Optum/Change Healthcare, UnitedHealthcare Link), Epic Care Link and dedicated pharmacy tools (CoverMyMeds), and direct telephonic/fax escalations to obtain expedited approvals.
- Record every touchpoint, payer conversation, submitted clinical document, and follow-up metric within the dedicated Epic EMR encounter to ensure complete transparency across UNLV Health.
- Review provider documentation, clinical notes, and diagnostic reports against specific payer criteria to submit a clean, highly justified authorization packet on the first attempt.
- Identify peer-to-peer review requirements or immediate administrative denials. Coordinate rapidly with ordering practitioners to supply missing clinical data or schedule payer-to-provider reviews to overturn denials quickly.
- Seamlessly transition between different ambulatory clinics daily or weekly, rapidly adapting to the distinct procedural workflows and medication profiles of diverse medical specialties.
- Proactively contact patients when complex drug formulas, specific DME models, or surgical dates face extensive insurance processing delays. Provide clear timeline updates and gather any required patient-reported historical data to push the approval forward.
Benefits
- Working Monday through Friday, 8AM to 5PM (Actual hours may vary depending on business need)
- 12 Full-Day and 2 Half-Day Paid Holidays per year, starting with your first day of employment
- 20 PTO days per year (Depending on Position)
- 3% 401K Contribution, even if you do not contribute
- Medical, Dental, and Vision benefits that start the first of the month following your start date
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
High school or GED
