Remote Jobs

Prior Authorization Specialist


PayCompetitive
LocationRemote
Employment typeFull-Time

This job is now closed

  • Job Description

      Req#: 5021290008
      Employer Industry: Healthcare Services

      Why consider this job opportunity:
      - Opportunity to work in a mission-driven organization focused on transforming women's mental health
      - Collaborate with a dynamic team of care managers, therapists, psychiatrists, and OB/GYN partners
      - Chance to build and improve processes, documentation, and workflows
      - Growth opportunities as the organization expands services and payer panels
      - Work remotely with flexible standard business hours

      What to Expect (Job Responsibilities):
      - Secure necessary approvals from payers for prior authorizations, precertifications, and referrals
      - Validate insurance eligibility and benefits for scheduled services in advance of patient appointments
      - Submit documentation and clinical records to payers for authorization requests and track their status
      - Maintain authorization logs and notify operational teams of any lapses or renewals needed
      - Act as a subject-matter expert on payer-specific authorization rules and internal processes

      What is Required (Qualifications):
      - High school diploma or GED required; Associate's or Bachelor's degree in health administration or related field preferred
      - Minimum 2-3 years of experience in healthcare provider services, prior authorization, or RCM
      - Strong knowledge of insurance eligibility, authorizations, CPT/HCPCS codes, and payer policies
      - Experience with Medicaid MCOs, FFS, Medicare Advantage, and commercial insurers
      - Excellent organizational, time-management, and documentation skills

      How to Stand Out (Preferred Qualifications):
      - Experience working in a behavioral health or women's health setting
      - Strong communication skills to interact effectively with payers, providers, and internal teams
      - Analytical mindset with the ability to identify trends and recommend process improvements

      #HealthcareServices #PriorAuthorization #MentalHealth #RemoteWork #CareerGrowth

      "We prioritize candidate privacy and champion equal-opportunity employment. Central to our mission is our partnership with companies that share this commitment. We aim to foster a fair, transparent, and secure hiring environment for all. If you encounter any employer not adhering to these principles, please bring it to our attention immediately.
      We are not the EOR (Employer of Record) for this position. Our role in this specific opportunity is to connect outstanding candidates with a top-tier employer."
  • About the company

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