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Pre-Authorization Specialist (Remote)

Remote, USA Full-time Posted 2025-11-03
About the position Responsibilities • Be well-versed in all 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 develop best practices to ensure we are providing the best service and experience to all customers • Maintain an assigned schedule, and be flexible with daily schedules when 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 ups, if necessary, to ensure timely approvals • Stay informed about insurance policies and guidelines, ensuring that all 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 extend beyond your day to day to stretch you to think outside the box Requirements • High School Diploma or equivalent required • A minimum of 2+ years of insurance pre-authorizations experience within a healthcare/medical billings environment is required • High-speed internet (50mbps connectivity) • Private, quiet place to work remotely • Exceptional attention to detail and organizational abilities • Strong knowledge of medical terminology, insurance policies, and healthcare regulations • High energy, be a self-starter, great teammate and ready to roll up your sleeves to get things done • Possess a strong work ethic and commitment to improving patients' lives while being flexible and adaptable with a drive to go above and beyond • Enjoys problem-solving in a dynamic, fast paced, team-based and rapidly changing environment • Provide excellent customer service by addressing inquiries from healthcare providers, patients, and insurance representatives regarding prior authorization status and requirements Nice-to-haves • Experience using Google Apps, Mac OS X, and CRM applications (i.e. Salesforce) strongly preferred • Associates preferred Benefits • Medical • Dental • Vision • Life • STD/LTD • 401(k) • Paid Time Off (PTO) or Flexible Time Off (FTO) • Tuition Reimbursement • Employee Stock Purchase Plan Apply tot his job Apply To this Job

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