Authorization Specialist
Remote · United States
Job Summary
Authorization Specialist responsible for all administrative aspects of outpatient diagnostic testing and procedure benefit verification and authorization, obtaining pre-authorizations for physician orders as required by insurance carriers, ensuring financial feasibility by communicating with patients, physicians, nurses and social workers, and maintaining up-to-date EMR/documentation on authorizations, denials, and referrals. The role involves denial management, retro authorization work, adherence to payer guidelines for medically necessary testing, and collaboration with front office and imaging staff; requires proficiency with EMR/EBS systems, accuracy, patient service skills, and the ability to handle projects and trainings as needed.
Required Qualifications
- High School diploma or equivalent
- One year experience in a directly related role preferred, but not required
- High School diploma or equivalent required
- 1+ year(s) of Prior Authorization experience
- Medical insurance background required
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