Prior Authorization and Benefits Verification Specialist
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Job Description
Remote specialist verifying insurance benefits and securing medical authorizations. Supporting healthcare providers with timely patient access and improved revenue cycle reimbursements.
Responsibilities:
- Support the Patient Access Onshore department with insurance verification and prior authorization functions
- Contact payers for eligibility, benefit information, and authorization requirements
- Obtain prior authorizations and pre-certifications
- Submit complete and accurate authorization requests
- Follow up on and resolve pending authorization requests
- Maintain documentation of authorization activity
- Stay current on payer prior authorization requirements
- Facilitate timely patient access to healthcare by managing prior authorization processes
Requirements:
- High School Diploma or equivalent
- 2+ years of experience in prior authorization and insurance eligibility/benefits verification
- Experience verifying coverage, deductibles, copays, coinsurance, and authorization requirements
- Ability to submit and track authorization requests, follow up with payers, and coordinate supporting documentation with provider offices
- Familiarity with medical terminology, CPT/ICD-10 codes, payer portals, and electronic health record systems
- Strong attention to detail, communication, organization, and follow-up skills
- Ability to manage multiple requests, meet turnaround times, and maintain patient confidentiality
- Experience with radiology/imaging and laboratory services preferred
- Experience resolving authorization denials and supporting appeals preferred
Benefits:
- Access to a 401(k) Retirement Savings Plan
- Comprehensive Medical, Dental, and Vision Coverage
- Paid Time Off
- Paid Holidays
- Pet Care Coverage
- Employee Assistance Program (EAP)
- Discounted services
- Flexible work hours when possible
- Diverse and inclusive workplace culture
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