Prior Authorization Specialist II
OU Health
- # Prior Authorization Specialist IIApply: WFH State of Oklahoma: Full time: Posted Today: R0069712## **Position Title:**Prior Authorization Specialist II## **Department:**Pre-visit Services## **Job Description:*****New to OU Health? Ask your recruiter about our competitive wages and total rewards package.*****Remote Eligibility:** Candidates must reside and work full-time in **OK** before their first day of employment.**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.
- J-18808-Ljbffr OU Health
Vacancy posted 1 day ago
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