Pre Authorization Specialist II
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Job Description
Remote Pre Authorization Specialist II supporting Labcorp’s diagnostic testing and healthcare reimbursement operations. Managing prior authorizations, benefit investigations, payer requirements, and timely billing support.
Responsibilities:
- Respond to high-volume pre-authorization billing tasks and inquiries
- Maintain response times across phone, chat, email, and portal platforms
- Examine incoming orders for complete and accurate prior authorization documentation
- Work with vendors to submit prior authorizations successfully
- Monitor prior authorization requests, follow up on pending cases, and initiate follow-ups to ensure timely approvals
- Stay informed about insurance policies and guidelines
- Maintain accurate records of prior authorization requests, approvals, and denials in databases
- Conduct benefit investigations and review payer medical policies
- Initiate and manage prior authorizations
- Provide patient cost estimates
- Partner with patients, health plans, clients, providers, insurance representatives, and internal stakeholders
- Support reimbursement and revenue cycle activities, timely billing, and reimbursement processes
- Identify issues, suggest improvements, and develop team best practices
- Maintain assigned schedules and adapt to changing business needs
- Participate in projects beyond day-to-day responsibilities
- Provide responsive, professional support regarding prior authorization status and requirements
Requirements:
- High school diploma with 3 or more years of relevant experience
- Associate degree or higher in Healthcare Administration, Business Administration, Health Information Management, or a healthcare-related field (preferred)
- 2 or more years of experience documenting healthcare authorization activities within authorization, billing, reimbursement, or revenue cycle management systems
- 2 or more years of experience working with Labcorp systems, including LCLS and/or LCBS
- 2 or more years of experience in Revenue Cycle Management (RCM) operations
- 1 or more years of experience using Microsoft Word, Excel, and Outlook in a healthcare, reimbursement, billing, or authorization environment
- Ability to work remotely from a private, quiet workspace
- Reliable high-speed internet connection (minimum 50 Mbps)
- Proficiency with Microsoft Office (Word, Excel, Outlook)
- Strong customer service, time management, and organizational skills
- Excellent verbal and written communication abilities
- High attention to detail with the ability to manage multiple priorities
- Solid understanding of medical terminology, insurance guidelines, and healthcare regulations
- Self-motivated, collaborative, and willing to take initiative
- Strong work ethic, flexibility, and commitment to supporting positive patient outcomes
- Problem-solving ability in a fast-paced, team-oriented, evolving environment
Benefits:
- Medical insurance
- Dental insurance
- Vision insurance
- Life insurance
- STD/LTD
- 401(k)
- Paid Time Off (PTO) or Flexible Time Off (FTO)
- Tuition Reimbursement
- Employee Stock Purchase Plan
- Remote work arrangement
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