Prior Authorization

Urology Centers of Alabama • Birmingham Township, PA

3d • Onsite

About The Position

The Prior Authorization Specialist coordinates and secures insurance authorization for medications, in-office injections, and imaging when needed to support timely patient care. This role involves reviewing payer requirements, gathering appropriate clinical documentation, and communicating with insurance companies, pharmacies, and internal staff to facilitate authorization approvals. The ideal candidate demonstrates strong time management, attention to detail, integrity, and the ability to manage multiple requests while maintaining organization and professionalism in a high-volume environment.

Requirements

• Familiarity with medical terminology and working knowledge of medical coding systems (CPT, ICD-10) relevant to prior authorization requests.
• Strong organizational and time management skills, with the ability to prioritize urgent requests and meet deadlines in a high-volume environment.
• Excellent written and verbal communication skills when interacting with patients, insurance representatives, pharmacies, and internal clinical staff.
• Ability to work both independently and collaboratively within a team while managing multiple tasks simultaneously.
• Demonstrates integrity, professionalism, and ethical decision-making when handling patient information and submitting prior authorization requests.
• HS Diploma or GED required.

Responsibilities

• Complete authorization submissions through electronic platforms, payer portals, and telephone communications with insurance representatives when required.
• Review patient charts to obtain relevant clinical documentation needed to support authorization requests
• Communicate professionally with insurance companies, pharmacies, patients, and internal staff regarding authorization requirements and status updates.
• Track and update prior authorization requests and outcomes using internal tracking tools and insurance portals to ensure timely processing and follow-up.
• Demonstrate accountability for assigned authorization requests by monitoring status and following up with payers when necessary.
• Actively monitor PA Pool and EHR inbox communications to ensure timely response to authorization requests and related inquiries.
• Ensure all prior authorization submissions and supporting documentation accurately reflect the patient’s medical record and comply with payer requirements.

What This Job Offers

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