Prior Authorization Specialist (Multi-Specialty) | Permanent WFH

Key Responsibilities

• Process and trackprior authorization requestsfor medications, procedures, and treatments.
• Verify patient insurance coverage, eligibility, and benefits.
• Collaborate with physicians, nurses, and insurance providers to obtain necessary approvals.
• Document and update all authorizations and communications inNextGen EMR.
• Identify and resolve prior authorization delays or denials in a timely manner.
• Maintain compliance with HIPAA and payer-specific guidelines.

Requirements

• Minimum3 years of experiencein prior authorization or medical billing/insurance verification.
• Strong knowledge inPulmonology, Gastroenterology, and Internal Medicineworkflows.
• Proficiency inNextGen softwarepreferred.
• Familiarity with payer requirements and medical terminology.
• Excellent communication, organizational, and problem-solving skills.
• Ability...