Prior Authorization Representative

Medix • New York, NY

435d • $43,680 - $52,000 • Remote

About The Position

The Prior Authorization Representative will be responsible for contacting insurance companies to verify patient benefits and coverage details, managing the submission of prior authorization requests for prescription medications, and serving as a liaison between patients, healthcare providers, and insurance companies. This role is crucial in ensuring that all necessary documentation is submitted and that any issues related to prior authorization requests are documented and escalated appropriately. The position offers a hybrid work model, with one week of onsite training in Manhattan followed by remote work.

Requirements

• 1+ years of experience working in healthcare operations, particularly in benefits verification, prior authorization, medical billing or coding.
• Understanding of medical terminology and insurance process.
• Attention to detail and strong organizational skills.
• Excellent communication skills and adept at using web-based tools/systems.
• Ability to work in person in Soho, NYC.

Responsibilities

• Contact insurance companies to verify patient benefits and coverage details.
• Manage submission of prior authorization requests for prescription medications via ePA, fax, and phone.
• Review clinical information and ensure all required documentation is included with submissions.
• Document and escalate any issues related to prior authorization requests, such as the need for additional information or documentation from providers.
• Serve as a liaison between patients, healthcare providers, and insurance companies.

Benefits

• Remote work after onsite training
• Flexible schedule
• Business casual dress code

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Industry: Administrative and Support Services
• Education Level: No Education Listed