Prior Authorization Specialist

To support a growing healthcare team, the full-time Prior Authorization Specialist will determine authorization requirements for outpatient services, submit requests for approval, and follow up with healthcare providers, all while working remotely. Key responsibilities Determine if payer authorization is required for outpatient diagnostic and surgical services using online resources or phone calls Submit authorization requests and gather clinical data as needed, escalating cases to physicians when necessary Follow client scripting guidelines for patient and physician outreach while ensuring compliance with HIPAA standards Required qualifications High School Diploma or GED equivalent Healthcare experience with familiarity in medical terminology Knowledge of multiple specialty and prior authorization processes preferred Understanding of the revenue cycle process Basic computer skills and familiarity with insurance carrier websites