Supporting the prior authorization request process, the full-time remote Authorization Specialist will manage complex authorization requests, verify member insurance coverage, and maintain documentation to ensure timely adjudication for payment. Key responsibilities Tracks and maintains authorization requests in accordance with insurance prior authorization lists and routes them to clinical reviewers Verifies member insurance coverage and service eligibility, aligning authorizations with guidelines for timely payment adjudication Acts as a subject matter expert on the authorization process, providing guidance and support to team members and maintaining relationships with service providers Required qualifications High School diploma or GED required 2 - 4 years of related experience in healthcare or insurance authorization Strong knowledge of medical terminology and insurance processes Ability to research health plan providers and policies for referral authorization Experience with data entry and maintaining complex authorization requests in a utilization management system
Authorization Specialist in workfromhome at Unknown Company
This position is listed as full time and able to be worked remotely.