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Medical Authorization Specialist
Job Summary
We are seeking a detail-oriented and organized Medical Authorization Specialist to join our healthcare team. This role is responsible for obtaining prior authorizations for medical procedures, diagnostic testing, and treatments while ensuring compliance with payer requirements and maintaining accurate patient records.
Key Responsibilities
- Obtain prior authorizations and referrals from insurance carriers for medical services
- Verify patient insurance eligibility and benefits
- Communicate with insurance companies, providers, and patients regarding authorization status
- Submit clinical documentation and follow up on pending authorizations
- Track and document authorization approvals, denials, and appeals
- Maintain accurate records in the electronic medical record (EMR) system
- Ensure compliance with HIPAA and payer guidelines
- Collaborate with clinical and billing staff to prevent delays in patient care
- Other duties pertaining to billing and AR follow up
Qualifications
- High school diploma or GED required
- Minimum 1–2 years of experience in medical prior authorizations, referrals, or insurance verification
- Knowledge of medical terminology, CPT, ICD-10, and HCPCS codes
- Familiarity with commercial insurance, Medicare, and Medicaid plans
- Strong attention to detail and organizational skills
- Excellent verbal and written communication skills
- Proficiency with EMR systems and Microsoft Office
Preferred Skills
- Experience working in a physician’s office, hospital, or specialty clinic
- Ability to manage multiple authorizations efficiently in a fast-paced environment
- Problem-solving skills and ability to follow up persistently with payers
Pay: $18.00 - $20.00 per hour
Benefits
- 401(k)
- Dental insurance
- Health insurance
- Life insurance
- Paid time off
- Vision insurance
People with a criminal record are encouraged to apply
