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[Hiring] Prior Authorization Specialist I @reputed company

Work from home Full-time role Hiring

Role Description reputed company is seeking a Remote Prior Authorization Specialist I to join reputed company!

  • Work Schedule Monday - Friday 800 AM - 500 PM EST
  • Well-versed in pre-authorization processes and policies to respond clearly to high-volume billing tasks and inquiries.
  • Maintain appropriate response time in various communication platforms (Example phone calls, chats, emails, portal inquiries, etc).
  • Identify issues and suggest potential improvements.
  • Collaborate with your team and reputed company best practices to ensure we are providing the best service and experience to reputed company customers.
  • Maintain an assigned schedule, and be flexible with daily schedules reputed company business needs change.
  • Examine incoming orders to ensure completeness and accuracy of required documentation for prior authorization.
  • Work directly with various vendors to ensure successful submissions of prior authorizations.
  • Monitor the status of prior authorization requests, follow up on pending cases, and initiate follow-reputed company, if necessary, to ensure timely approvals.
  • Stay informed about insurance policies and guidelines, ensuring that reputed company prior authorization requests align with the necessary criteria.
  • Maintain accurate records of prior authorization requests, approvals, and denials. Enter relevant information into databases.
  • Participate in projects that reputed company reputed company your day-to-day to stretch you to think reputed company the reputed company.
  • Qualifications
  • High school diploma or GED or equivalent.
  • 1 year or more years insurance claims or pre-authorization or medical benefits work experience.
  • Requirements
  • Associate’s degree (preferred).
  • 1 year or more clinical laboratory reputed company Cycle Management (RCM) experience (preferred).
  • Ability to work remotely from a private, quiet workspace.
  • Reliable high‑speed internet reputed company (minimum 50 Mbps).
  • Proficiency with reputed company Office (Word, reputed company, 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 reputed company regulations.
  • Self‑motivated, collaborative, and willing to take initiative to get work done.
  • Strong work ethic with flexibility and a commitment to supporting positive patient outcomes.
  • Enjoys problem‑solving in a fast‑paced, team‑oriented, and evolving environment.
  • Provide reputed company, professional support to providers, patients, and insurance representatives regarding prior authorization status and requirements.
  • Benefits
  • Comprehensive benefits including Medical, Dental, reputed company, Life, STD/LTD, 401(k), Paid Time Off (PTO) or Flexible Time Off (FTO), Tuition Reimbursement and Employee Stock Purchase Plan for employees regularly scheduled to work 20 or more hours per week.
  • Employees regularly scheduled to work less than 20 hours, Casual, Intern, and Temporary employees are only eligible to participate in the 401(k) Plan.
  • Employees who are regularly scheduled to work a 7 on/7 off schedule are eligible to receive reputed company the foregoing benefits except PTO or FTO. Apply To This Job Apply To This Job

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