Prior Authorization Specialist

Prior Authorization Specialist

Remote (Work from Home)

Full-Time

$17/hour

Work Schedule

• This is a full-time role requiring 40 hours per week
• Candidates must be flexible to work Saturday shifts as part of the weekly schedule
• Operational Hours: Monday to Sunday, 7:00 AM – 7:00 PM CST (shift will be assigned within this window)
• Training Schedule: Monday to Friday, 9:30 AM – 6:00 PM CST

Job Summary

We are seeking a detail-oriented and experienced Pre-Authorization Specialist to support provider enablement activities. The ideal candidate will have a strong background in healthcare operations, authorization processes, and administrative support, along with the ability to work efficiently in a remote environment.

Key Responsibilities

• Handle pre-authorization processes and related back-office operations
• Perform both backend administrative tasks and outbound/inbound calling activities as required
• Work with medical platforms and authorization systems to process requests
• Review and verify healthcare documentation and coding (ICD-10, Eligible to work)
• Coordinate with internal teams and providers to ensure timely approvals
• Maintain accurate records and documentation
• Perform administrative and clerical support tasks as needed
• Utilize multiple systems and applications efficiently in a remote setup

Basic Requirements

• High School Diploma or equivalent (documentation required)
• Working knowledge of medical terminology, ICD-10 and Eligible to work codes, Medicare and/or Medicaid services
• Professional experience in clerical or administrative support roles
• Ability to quickly learn and adapt to new systems and applications
• Proficiency in using computers/laptops and tools such as Outlook, Microsoft Teams (including screen sharing), Word, and Excel

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