Prior Authorization Specialist Jobs

About The Position

Requirements

• High School Diploma, GED, or HiSET required
• Ability to complete Patient Financial Services training within 5 months of hire
• Understanding and knowledge of medical terminology, anatomy, physiology, and disease processes
• Strong communication and interpersonal skills with a customer-first mindset
• Highly organized with the ability to prioritize multiple tasks and deadlines
• Comfortable using computer systems and skilled in accurate data entry and keyboarding.
• Professional, dependable, and team-oriented

Responsibilities

• Coordinate and process prior authorization requests for hospital services with accuracy, efficiency and in accordance with established criteria and protocols
• Confirm insurance eligibility and secure all required authorizations, referrals, and notifications to support patient care services.
• Communicate and partner closely with external physician offices and internal hospital departments to maintain accurate patient and authorization records within electronic systems
• Provide support to patients, providers, and clinical staff while ensuring accurate insurance verification and compliance with managed care agreements and authorization requirements
• Serve as a trusted resource to clients and internal staff
• Help ensure compliance with payer guidelines, managed care contracts, and hospital policies
• Support additional administrative and departmental initiatives as needed