Authorization Specialist

Job Title

Required Skills & Experience: Prior authorization experience within plastic surgery, radiology, or outpatient procedures. Experience working with out-of-network providers or gap exception requests. Experience supporting surgical or procedure-based authorization workflows. Familiarity with Blue Cross Blue Shield or other high-volume commercial payers. Experience supporting appeals, denials, peer-to-peer coordination, or medically necessary documentation requests.

Nice to Have Skills & Experience: Detail oriented, persistent and resourceful, gritty.

Job Description

2+ years of experience in a healthcare environment. Hands-on experience with prior authorizations, insurance verification, payer follow-up, referrals, denials, or related revenue cycle workflows. Experience using insurance portals, ideally Availity and/or Navinet. Strong understanding of medical terminology and general medical office procedures. Ability to communicate professionally with insurance representatives, providers, physicians, surgical coordinators, and internal staff. Strong attention to detail, organization, documentation accuracy, and ability to manage multiple pending cases at once.