[Remote] Authorization Specialist II
Note: The job is a remote job and is open to candidates in USA. RemoteHunter is connecting candidates with leading employers in the healthcare sector, specifically in the Medical Management/Health Services team. The Authorization Specialist II will support the prior authorization request process, ensuring timely and accurate handling of authorization requests related to member healthcare eligibility and access.
Responsibilities
- Support prior authorization request process within contractual timelines
- Document authorization requests and obtain timely, accurate service documentation
- Track and maintain documentation on authorizations and referrals per policies
- Research and document medical information for clinical reviewer determination
- Verify member insurance coverage and service eligibility using system tools
- Perform data entry to update authorization requests in the utilization management system
- Process authorization requests per insurance prior authorization list and route appropriately
- Stay current on healthcare, authorization processes, policies, and procedures
- Perform other duties as assigned
- Comply with all policies and standards
Skills
- High School diploma or GED
- 1 to 2 years of related experience
- Knowledge of medical terminology and insurance
Benefits
- Competitive pay
- Health insurance
- 401K and stock purchase plans
- Tuition reimbursement
- Paid time off and holidays
- Flexible work options including remote, hybrid, field, or office schedules
Company Overview