Prior Authorization Specialist
$47,840–$56,160 year
On-site · Brea, California, United States
Job Summary
Prior Authorization Specialist needed to support patient care operations at Brea HQ. This full-time, onsite role focuses on timely, accurate submission, follow-up, and approvals of authorizations. The specialist will review information for accuracy, assist with medical necessity documentation to expedite approvals, collaborate with other departments to obtain authorizations/appeals, and document interactions and authorization details in the patient profile. Responsibilities include proactively managing expiring authorizations, adhering to company policies and applicable laws, and completing duties and reports as directed. Requires at least 2 years of infusion or pharmacy prior authorization experience, familiarity with Medicare/Medicaid/Managed Care reimbursement guidelines, and proficient Microsoft Excel and Word skills.
Required Qualifications
- At least 2 years experience in infusion or pharmacy prior authorization
- At least 2 years of experience applying knowledge of Medicare, Medicaid, and Managed Care reimbursement guidelines
- Intermediate level skills in Microsoft Excel & Word
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