Prior Authorization Specialist

To support a growing healthcare practice, the full-time Prior Authorization Specialist will obtain prior authorizations and pre-certifications for diagnostic testing, medical procedures, and specialty medications while working remotely. Key Responsibilities Obtain prior authorizations and pre-certifications for various diagnostic tests, procedures, and specialty medications Verify patient insurance coverage, benefits, and authorization requirements, and submit necessary clinical documentation to insurance carriers Monitor authorization requests, communicate outcomes to relevant stakeholders, and assist with appeals for denied authorizations Required Qualifications High school diploma or equivalent required; Associate's degree preferred Minimum of 2 years of experience with medical insurance verification, prior authorizations, and pre-certifications Knowledge of medical terminology, diagnostic testing, and healthcare insurance processes Familiarity with electronic medical record (EMR) systems and insurance payer portals Understanding of HIPAA regulations and patient confidentiality requirements