Prior Authorization Specialist

Prior Authorization Specialist

Bartlett Regional Hospital is searching for a Prior Authorization Specialist to join our Prior Authorization Team!

Pay Information: Internal Hires: Pay rate will be determined based on applicable personnel rule or union contract terms.

Prior Auth Specialist 1: The Prior Authorization Specialist 1 performs routine prior authorization and insurance verification functions in support of patient access and revenue cycle operations. Under general supervision, this role determines authorization requirements, verifies insurance coverage and eligibility, submits standard requests, and monitors status to ensure timely processing and scheduling. The position follows established workflows, ensures required documentation is complete, communicates updates with staff and payers, and escalates complex issues as needed while developing foundational knowledge of payer requirements, insurance verification, and authorization processes.

Prior Auth Specialist 2: The Prior Authorization Specialist 2 independently manages prior authorization and insurance verification processes across multiple service lines, ensuring accurate eligibility determination, timely approval of services, and minimal delays in patient care. This role applies advanced knowledge of payer requirements, benefit structures, clinical documentation standards, and authorization workflows to resolve complex issues, including denials, coverage discrepancies, and incomplete requests. The Specialist 2 serves as a resource to staff and providers on authorization and insurance-related questions, supports process improvement efforts, and helps identify trends impacting access and reimbursement. This position is responsible for ensuring accuracy, compliance, and efficiency across all authorization and insurance verification activities.

Minimum Qualifications for the Job:

Prior Auth Specialist 1

• Education: High School diploma or equivalent
• Experience: One (1) year of experience in data entry, billing, accounting, or similar experience
• License(s): None
• Certification(s): None

Prior Auth Specialist 2

• Education: High School diploma or equivalent
• Experience: One (1) year of direct prior authorization experience in a hospital
• License(s): None
• Certification(s): None

Practice Notices:

• All new employees are required to produce a negative drug screen for all illegal substances in the State of Alaska prior to start of employment.

Qualifications

Education: Preferred High School Diploma or Equivalent or better in General Studies.

Licenses & Certifications: Required SOA Background Check, Employee Health, Healthstream Training

Equal Opportunity Employer This employer is required to notify all applicants of their rights pursuant to federal employment laws. For further information, please review the Know Your Rights notice from the Department of Labor.