Prior Authorization Specialist

Detail-oriented and passionate about healthcare, the full-time Prior Authorization Specialist will work remotely to ensure efficient processing of prior authorizations for procedural orders, including obtaining necessary documentation and verifying patient information. Key responsibilities: Obtain prior authorizations for facility and professional charges following departmental protocols Submit CPT and HCPCS codes and medical records to insurers to expedite authorizations Verify patient demographics and medical details, ensuring HIPAA compliance Required qualifications: 2+ years of experience in a hospital, specialty clinic, or medical billing setting focused on pre-certifications or prior authorizations Knowledge of commercial and government insurance requirements, ICD-9/CPT codes, and medical terminology Familiarity with Microsoft Office and willingness to learn new software Strong English communication skills, both written and verbal Understanding of reimbursement and claims procedures and their impact on the revenue cycle