Prior Authorization Specialist

TEKsystems • Wallingford, CT

8d • $20 - $23 • Onsite

About The Position

A leading cardiology practice is seeking a Prior Authorization Specialist to support patient care by securing timely insurance approvals for procedures, imaging, testing, and medications. This role requires strong experience with prior authorizations, insurance verification, and Explanation of Benefits (EOBs).

Requirements

• 1-3 years of prior authorization, insurance verification, or medical office experience
• Experience with Prior Authorizations, Pre-Authorizations, and EOBs
• Knowledge of healthcare insurance plans and payer processes
• Familiarity with EMR systems and medical terminology
• Strong attention to detail, organization, and communication skills

Nice To Haves

• Cardiology experience preferred

Responsibilities

• Submit, monitor, and obtain prior authorizations for cardiology procedures, diagnostic testing, imaging studies, and medications
• Perform insurance verification to confirm patient benefits, coverage, and authorization requirements
• Review and interpret Explanation of Benefits (EOBs) and payer communications
• Communicate with insurance carriers, providers, and patients regarding authorization status and requirements
• Follow up on pending authorizations and resolve denials, appeals, or requests for additional clinical information
• Maintain accurate and complete documentation within the EMR system
• Stay current on payer guidelines, coverage policies, and cardiology-specific authorization requirements
• Collaborate with providers and clinical staff to ensure timely patient scheduling and treatment

Benefits

• Medical, dental & vision
• Critical Illness, Accident, and Hospital
• 401(k) Retirement Plan – Pre-tax and Roth post-tax contributions available
• Life Insurance (Voluntary Life & AD&D for the employee and dependents)
• Short and long-term disability
• Health Spending Account (HSA)
• Transportation benefits
• Employee Assistance Program
• Time Off/Leave (PTO, Vacation or Sick Leave)

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: No Education Listed