Prior Authorization Specialist (Remote, Night-Shift)

We’re Hiring: Prior Authorization Specialist (Remote, Night-Shift)

Prior Authorization Specialist

Location:

Shift: Night

Key Responsibilities:

Prior Authorization Process Management:

• Complete and submit prior authorization forms accurately and promptly to insurance companies.
• Monitor the status of prior authorization requests and follow up with insurance companies as needed to expedite approvals.
• Maintain organized records of all prior authorization requests, approvals, and denials.
• Review denials and follow up with the provider to obtain the medically necessary information to submit an appeal if needed.

Insurance Verification and Assessment:

• Verify insurance coverage and assess clients' insurance cards for relevant information, including eligibility, coverage limits, and authorization requirements.

Liaison with Insurance Companies and Pharmacies:

• Make outbound calls to insurance companies and pharmacies to gather information and resolve any issues related to prior authorizations.
• Communicate authorization status to internal team members and patients as needed.

Documentation and Reporting:

• Maintain accurate and up-to-date documentation of all interactions, authorizations, and communications related to prior authorizations.

Requirements:

• Prior U.S.-based healthcare experience is mandatory.
• Strong knowledge of insurance processes, prior authorization procedures, and medical terminology.
• Excellent communication, organizational, and multitasking skills.
• Ability to work independently in a remote night-shift environment.

If you are detail-oriented, proactive, and passionate about helping patients receive timely care, we want to hear from you!

Apply now and join the DODO COLE team. --