Authorization Specialist I

Prior Authorization Specialist Responsibilities Process and manage prior authorization requests for services in accordance with insurance guidelines. Work efficiently from a queue of incoming authorizations received via Outlook or FileNet. Perform accurate data entry to maintain, update, and document authorizations within the utilization management system. Conduct proactive outreach to providers and members, generating necessary correspondence and letters. Assist the utilization management team with ongoing tracking and documentation of authorizations and referrals. Contribute to the clinical review process by accurately documenting essential medical information (e.g., patient history, diagnosis, prognosis) for reviewers. Stay current on healthcare regulations, authorization processes, and internal policies. Perform other related duties as assigned. Performance metric: approximately 1.5 cases per hour. Qualifications 1 to 2 years of experience in a Prior Authorization Specialist role or similar capacity. Solid understanding of medical terminology and health insurance protocols. Tech‑savvy multitasking ability: navigate multiple software systems while communicating with providers or members. Exceptional written and verbal communication skills with professional phone etiquette. Strict attention to detail and strong clinical documentation skills. High School education required. Compensation & Schedule Salary: $22.98 - $23.00 per hour Shift: First (8:30 AM – 4:00 PM) Equal Opportunity Employer This is an equal opportunity employer. We welcome people of all abilities and provide reasonable accommodations during the hiring process. EEO Statement We are an Equal Opportunity Employer: Race, Color, Religion, Sex, Sexual Orientation, Gender Identity, National Origin, Age, Genetic Information, Disability, Protected Veteran Status, or any other legally protected group status. #J-18808-Ljbffr Randstad USA