PRIOR AUTHORIZATION SPECIALIST
Graves Gilbert Clinic
The Prior Authorization Specialist is responsible for verifying patient eligibility and insurance benefits for clinic-administered medications. This position requires a thorough understanding of insurance terminology, benefit structures, and authorization processes to ensure accurate documentation and timely completion of prior authorization requests. The Specialist will obtain, monitor, and maintain authorizations through payer websites, fax, and telephone, including all necessary follow-up and reauthorization activities. This role supports revenue cycle accuracy and contributes to the delivery of high-quality patient care.
Key Responsibilities:- Initiate, monitor, and secure prior authorizations from third-party payers.
- Maintain electronic documentation for all prior authorization activities in accordance with organizational standards.
- Track pending authorizations and follow up within defined timeframes (7-10 days or payer-specific requirements) to support timely claims submission.
- Obtain authorization renewals and verify active provider orders and medical necessity documentation.
- Work collaboratively with clinicians, practice managers, and other team members to obtain clinical notes and documentation necessary for prior authorization approval.
- Verify authorization quantities and effective dates; ensure accurate processing by third-party payers and correct loading of information in internal systems.
- Review and confirm patient eligibility, insurance benefits, and plan requirements for clinic-administered medications.
- Interpret payer pre-certification and authorization guidelines and ensure appropriate approvals are obtained and documented.
- Input accurate Payer Plan ID numbers and related data into organizational systems to ensure correct billing for current and future services.
- Determine patient financial responsibility, including coordination of benefits and other coverage considerations.
- Organize workload and manage deadlines to prevent delays or loss of revenue due to filing limitations.
- Maintain professional communication with all payers, clinicians, and other team members.
- Perform additional duties as assigned.
- Prior experience in authorization processing and benefit investigation required.
- Experience with specialty medication authorizations preferred.
- Strong attention to detail and accuracy.
- Excellent time management and organizational skills.
- Proficiency in Microsoft Excel and related software applications.
- Strong interpersonal and communication skills.
- Ability to interpret insurance benefits, authorization guidelines, and medical terminology.
- Ability to work collaboratively in a fast-paced, team-oriented environment.
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.
- ...Patient Scheduling, Insurance Authorization, and Financial Clearance Full Time Day Shift 7:00am/7:30am/8:00am to 3:30... ...patient experience. Position Summary The Authorization Specialist is responsible for obtaining prior authorizations, precertifications, and other payer-...SuggestedFull timeWork at officeDay shift
$850 - $1,200 per week
...Lawn Specialist 1451 Bowling Green Rd, Russellville, Kentucky 42276 TruGreen accepts applications on an ongoing basis. Job Description At TruGreen, we believe every lawn holds potential and so does every team member. As a Residential Lawn Care Specialist,...SuggestedHourly payLocal area- O'Reilly Auto Parts in Bowling Green, KY is seeking a Delivery Driver to ensure safe and efficient delivery of parts to stores and distribution centers. Responsibilities include maintaining daily route manifests and ensuring vehicle maintenance. The ideal candidate will...Suggested
- Job Details Job Location: Pan Oston - Bowling Green, KY 42101 Position Type: Full Time Education Level: High School/GED Travel Percentage: Negligible Job Shift: Day Job Category: Manufacturing Are you looking for your forever career? Do you strive for success? Come join...SuggestedFull timeTemporary workWork experience placementImmediate startShift work
- ...The Parts Specialist will provide all retail and installer customers with a high level of service. This position will also support store management in the accomplishment of assigned tasks. Bilingual candidates encouraged to apply. ESSENTIAL JOB FUNCTIONS...SuggestedLocal areaFlexible hours
- ...Compensation $ Hours Per Week 40 Number Of Positions 1 Job Description Position Title: FIRST IMPRESSION SPECIALIST Requisition Number: FIRST003263 Location: Bowling Green, KY 42101, USA Job Category: Central Registration Position Type: Full-Time...Full timeWork at office
- ...store management. Clock in/out according to company policy. Check fluid levels (oil, radiator, transmission, etc.) and log mileage prior to operating the vehicle each day. Report vehicle maintenance needs immediately to the store manager. Ensure fuel tank is filled, and...Local areaImmediate startFlexible hours
- ...The Delivery Specialist will maintain and operate store vehicles to deliver parts and/or products to professional customers in a safe and... ...vehicles clean, maintained, and complete daily vehicle inspections prior to operating. Keep delivery vehicles, keys, fuel/fleet credit...Local areaImmediate startFlexible hours
- A financial services company in Bowling Green is seeking a motivated individual for a dynamic role that allows work from home and flexibility. You will conduct virtual consultations, assess client needs, and build lasting relationships. The company offers a qualified lead...Work experience placementRemote workWork from homeFlexible hours
- ...Permit Specialist Ledcor Technical Services has been building and servicing communication networks for customers across North America... ...accurate permit packages with local, state, and federal authorities to ensure timely approvals Present projects to neighborhood...Full timeWork at officeLocal areaRemote workWork from home
- ...The Parts Specialist will provide all retail and installer customers with a high level of service. This position will also support store management in the accomplishment of assigned tasks. Bilingual candidates encouraged to apply. ESSENTIAL JOB FUNCTIONS...Local areaFlexible hours
- ...Job Description Position Purpose: The Asset Protection Specialist is primarily responsible for preventing financial loss caused by theft and fraud and supporting safety and environmental program compliance in their assigned store/multiple stores. They utilize tools...Local area
- ...About the job Remote Disney Vacation Specialist Job Description: As a Remote Disney VacationSpecialist, you will be an essential part of our team, guiding clients through every stage of their journey, from the moment they plan their trip to their safe return home. Your...Remote work
- The Cocoon providessafety, healing and justice for survivors of domestic and sexual violence.The Cocoon works to live its vision to be a trusted partner, community leader and transforming voice in Wood County and surrounding areas, committed to ending domestic and sexual...Weekend work
- ...still a family‑owned company. Our core values and our people‑first culture remain the same. Description As one of our CDL Delivery Specialists, you will be responsible for transporting orders to local customer jobsites in a safe and timely manner using our well‑maintained...Full timeTemporary workLocal areaNight shift
- Children’s Hospital of Michigan Pediatric Neurologists in Detroit, MI Practice Pediatric Neurology in a High-Acuity, Academic, Multidisciplinary Environment At Children’s Hospital of Michigan, pediatric neurologists practice within a system built for complex care...Flexible hoursWeekend work
- ...Positioning Matrix based on spend, sales, market and supplier analysis. Qualification Summary To qualify for a Sourcing Strategy Specialist, your resume and supporting documentation must support: Specialized experience: One year of specialized experience that equipped...Full timeRemote work
- ...Overview Milton Hershey School, a cost-free pre-K through 12th grade residential school, is seeking a Youth Development Specialist in the Education, Training & E-Learning department. This role supports students’ academic, social, and emotional growth through mentoring...Full time
- Food Service Associate This is so much more than just a job! Come join a company where you have an opportunity to be an owner. We are a 100% Employee-Owned Company. It takes a special person to be an Associate with Huck's. Our standards for customer service and store...Work at officeLocal areaImmediate startAll shifts
$16 - $23 per hour
Overview Join to apply for the Cafe Associate role at Sam's Club . The base pay range is provided by Sam's Club. Your actual pay will be based on your skills and experience — talk with your recruiter to learn more. Base pay range $16.00/hr - $23.00/hr Position summary ...Hourly payMinimum wageTemporary workImmediate startFlexible hours$21 per hour
...the job. We're hiring part-time Doorstep Trash Collection Specialists (Service Valets) to help keep apartment communities clean, safe... ...updates, scheduling, and work-related information. Authorized to work in the U.S. (proof required). Ability to work independently...Hourly payExtra incomeFull timePart timeSecond jobLocal areaImmediate startWork from homeLong distance10 hours per weekShift workNight shiftDay shiftAfternoon shift- Job Description Job Description Description: Position Summary Provide Intensive Family Preservation Services using the HOMEBUILDERS® model, including crisis intervention, counseling, skill building, concrete services, and advocacy. Serve two to three families at...10 hours per weekFlexible hoursAfternoon shift
- Sam's Club | Medical, Dental, Vision, Rx + 401(k) with match + PTO + 100% Reimbursement of Tuition & Books | 3200 Ken Bale Boulevard | Responsibilities: Operate forklift safely and according to standards; Receive, stock, and organize merchandise and supplies; Provide member...Immediate start
- Are you looking for your forever career? Do you strive for success? Come join our Pan-Oston family and enjoy a great working experience with us!Pan-Oston Company is an industry leader in providing metal and wood fixtures to some of retails largest members and is a Houchens...Temporary workWork experience placementImmediate start
- Walmart Stores | Medical, Dental, Vision, Rx + 401(k) with match + PTO + 100% Reimbursement of Tuition & Books | 150 Walton Avenue | Responsibilities: Ensure customers have a great first and last impression; Change oil, tires, and other general maintenance; Become certified...Immediate start
$17 per hour
Experience Required 1 - 20 years Minimum Education Required High School Diploma/G.E.D. Compensation $17.00 - $17.00 / hourly Hours Per Week 20 Number Of Positions 1 Work Schedule and Shift Requirements First (Day) Job Description Community...Hourly payFull timePart timeCasual workLocal areaShift workNight shiftWeekend workDay shift$16 - $23 per hour
Position Summary Why do our members choose to purchase fruits & vegetables at Sam’s Club? Our members tell us one of the biggest reasons is they get quality & fresh food at low cost. As a part of our produce team, you’ll make important decisions about the quality of the...Hourly payMinimum wageFull timeTemporary workPart timeImmediate startFlexible hours- Overview Our Seasonal Sales Associates promote our culture, values and mission. As a Seasonal Sales Associate, your number one job is to share your love of fashion and do whatever it takes to create an amazing shopping experience for our customers. Who You Are:...Seasonal workWork at officeLocal areaFlexible hoursAfternoon shift
$15 per hour
Music & Arts is the nation's leading partner in K-12 music education. In this seasonal role, you'll help bring school instrument rental events to life across your area. Working with our Education Account Managers, you'll pitch in with event set-up, prep, and checklists...Seasonal workLocal areaFlexible hoursAfternoon shift- A multinational technology company is seeking interns for a role as Journalist and FB Administrator. This internship offers the opportunity to work from home and involves publishing articles and promoting the company’s website on social media platforms. Ideal candidates...Full timeInternshipRemote workWork from home
Do you want to receive more vacancies?
Subscribe and receive similar vacancies to PRIOR AUTHORIZATION SPECIALIST. Be the first to apply!
- amazon specialist Bowling Green, KY
- specialist Bowling Green, KY
- infection control specialist Bowling Green, KY
- writing specialist Bowling Green, KY
- process specialist Bowling Green, KY
- governance specialist Bowling Green, KY
- bank reconciliation specialist Bowling Green, KY
- consulting specialist Bowling Green, KY
- drug safety specialist Bowling Green, KY
- candidate experience specialist Bowling Green, KY



