Prior Authorization Specialists

• Contacting payors for eligibility and benefit information to include authorization requirements
• Obtain prior authorizations and pre-certifications
• Submit complete and accurate authorization requests        
• Follow up and resolve pending authorization requests         
• Maintain documentation of authorization activity      
• Stay current on payer prior authorization requirements

• 2+ years of experience in healthcare administration or prior authorization processes in orthopedics or physical/occupational therapy setting 
• Experience reviewing and processing prior authorization requests for medical procedures and services
• Ability to collaborate with healthcare providers and payers to resolve prior authorization issues and appeals
• Medical Assistant Certification or 5 years experience in a providers office setting processing prior authorizations is preferred but not required.  

Last updated on Oct 2, 2024