Prior Authorization Specialist
About The Position
Anchor Health is Connecticut’s leading center for inclusive, person-centered healthcare. We deliver compassionate, evidence-based primary, behavioral, and gender-affirming care for the LGBTQ+ community and beyond. Our mission is to empower every individual to live their healthiest life through exceptional, affirming care. At Anchor, you’ll join a collaborative team redefining what inclusive healthcare looks like across Connecticut with breaking down barriers, affirming identity, and raising the standard of care for all. The Role This role is responsible for prior authorization workflows, patient-specific electronic fax management, and clinical support within the EPIC EMR, ensuring timely, accurate coordination across patients, providers, and clinic staff. The ideal candidate brings strong organizational discipline, clear communication, and the ability to operate effectively in a fast-paced clinical environment. Success in this role requires attention to detail, comfort with structured processes, and a commitment to supporting reliable, patient-centered care.
Requirements
- 2+ years of experience with prior authorizations or insurance verification strongly preferred.
- Familiarity with EPIC
- Strong communication, problem-solving, and organizational skills.
- Ability to work both independently and collaboratively within a clinical team.
- Knowledge of medical terminology, medications, and insurance processes
Nice To Haves
- Certified Medical Assistant (CMA/RMA) or Pharmacy Technician (CPhT) strongly preferred.
Responsibilities
- Complete medication and procedural prior authorizations through CoverMyMeds, payer portals, phone calls, and electronic systems.
- Communicate with insurance companies to clarify coverage requirements, criteria, and documentation needs.
- Collaborate with providers to gather clinical information needed for approvals.
- Communicate with patients regarding prior authorization updates, medication issues, or required documentation.
- Track, follow up, and document all authorization statuses to ensure timely patient access to care.
- Assist providers and nurses with prior authorization questions, refill coordination, and pharmacy communication.
- Monitor, organize, and route incoming e-faxes to the appropriate clinical team members in EPIC
- Ensure timely processing of forms, lab results, medication requests, and other clinical documents incoming from e-fax
- Support clinic staff with administrative tasks such as scheduling, patient outreach, and medical record requests.
- Assist in coordinating referrals, diagnostic testing, and follow-up care.
- Maintain confidentiality and compliance with HIPAA and clinic policies.
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What This Job Offers
Job Type
Full-time
Career Level
Entry Level
Education Level
No Education Listed
