Prior Authorizations Specialist
UNITED MEDICAL DOCTORS MASTER•Carlsbad, CA
•$23 - $28•Onsite
About The Position
We are seeking an experienced and detail-oriented Prior Authorization Specialist to join our growing team. The ideal candidate will have extensive knowledge of insurance authorization processes across multiple specialties and the ability to manage high-volume requests for several clinic locations. This role requires a proactive professional who can work independently, communicate effectively with providers and insurance carriers, and ensure timely approvals to support quality patient care.
Requirements
- Minimum 3+ years of prior authorization experience in a medical setting
- Experience handling multiple specialties required
- Strong understanding of commercial insurance, Medicare, Medi-Cal, and managed care plans
- Familiarity with imaging and pre-certification insurance portals such as Availity, RadMD, eviCore, AIM/Carelon, and payer-specific portals
- Ability to manage authorizations for multiple clinic locations simultaneously
- Excellent organizational and time-management skills
- Strong verbal and written communication skills
- EMR/EHR experience required
- Ability to work independently and in a fast-paced environment
Nice To Haves
- Knowledge of GI, pain management, imaging, urology, and cardiology authorizations preferred
Responsibilities
- Submit and track prior authorization requests for: GI procedures, Pain management services, Imaging studies, Urology and cardiology services as needed
- Verify insurance eligibility and benefits
- Obtain and document authorizations accurately and efficiently
- Follow up with insurance companies regarding pending, delayed, or denied requests
- Coordinate with physicians, clinical staff, and scheduling teams across multiple locations
- Maintain accurate documentation within the EMR system
- Ensure compliance with payer guidelines and company policies
- Assist with appeals, reconsiderations, and peer-to-peer coordination when necessary
- Prioritize urgent requests while maintaining high accuracy standards
- Utilize insurance and imaging/pre-certification portals to process and manage authorizations, including platforms such as Availity, RadMD, eviCore, Carelon/AIM, and other payer-specific portals
Stand Out From the Crowd
Upload your resume and get instant feedback on how well it matches this job.
Upload and Match Resume
What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
No Education Listed
