Senior Pre-Authorization Specialist

LAKE REGION HEALTHCARE•Fergus Falls, MN

3d•$24 - $33•Onsite

About The Position

The Senior Pre-Authorization Specialist facilitates the gathering of information to verify medical necessity and meet prior authorization and insurance referral requirements. The role reviews and processes prior authorization and external referral requests, coordinates authorization and referral information with providers, clinics, and hospital departments, and helps ensure that required orders, notifications, and documentation are completed before scheduled procedures. The specialist also supports Revenue Cycle Leadership with denial management, tracking, and new service line development projects. This is an 80-hours-biweekly position on day shifts, Monday through Friday, at Lake Region Healthcare Corporation in Fergus Falls, Minnesota. The hourly wage range is $23.77–$32.78; final compensation depends on experience, qualifications, and internal equity considerations. The position requires attendance at the work site according to schedule.

Requirements

LPN or a two-year healthcare degree required.
Ability to communicate proficiently and professionally, verbally and in writing.
Successful completion of the pre-employment health screening process required.
Must be able to attend the work site according to schedule.

Nice To Haves

Experience or knowledge of authorizations, referrals, verifications, CPT and ICD-10 coding, and the medical claims process is desired.

Responsibilities

Review and process prior authorization and external referral requests.
Gather required clinical documentation and apply payer-specific guidelines and medical necessity criteria.
Communicate with insurance companies and providers about authorization status and outcomes.
Escalate cases for physician review when necessary.
Coordinate authorization and referral information with providers, clinics, and hospital departments.
Ensure required orders and notifications are completed before scheduled procedures.
Collaborate with clinical teams to meet documentation requirements.
Assist Revenue Cycle Leadership with projects related to denial management, tracking, and new service line development.