Prior Authorization Specialist II

Job Description Position Title Prior Authorization Specialist II Department Pre-visit Services Remote Eligibility Remote Eligibility: Candidates must reside and work full-time in OK before their first day of employment.

SHIFT

SHIFT: M-F, Days. Will need to be on-site as needed, at least monthly. Ideal candidate will have experience in pre-visit services for multiple areas, working with authorizations.** General Description Under general supervision, the Prior Authorization Specialist II effectively manages complex authorizations across multiple payers and specialties. Essential Job Duties Responsibilities listed in this section are core to the position. Inability to perform these responsibilities, with or without an accommodation, may result in disqualification from the position. Independently manage complex and specialty‑specific authorization requests. Interpret payer medical policies and utilization management criteria. Resolve authorization denials and incomplete determinations. Coordinate with clinical teams to obtain medical necessity documentation. General Job Duties Performs other duties as assigned Minimum Requirements Education: High School Diploma or GED required. Experience: At least 3 years of prior authorization experience required. Certification/License/Registration: CHAA or PACS required after 1 year. Knowledge, Skills & Abilities Applied expertise in payer medical policy interpretation. Strong knowledge of specialty‑driven authorization requirements. Ability to analyze denial trends and recommend corrective actions. Excellent written and verbal communication skills. OU Health is an equal opportunity employer. We offer a comprehensive benefits package, including PTO, 401(k), medical and dental plans, and many more. We know that a total benefits and compensation package, designed to meet your specific needs both inside and outside of the work environment, create peace of mind for you and your family. #J-18808-Ljbffr OU Health