Hospital Authorization Specialist

This is a fully remote position, open to applicants in Washington.

📋 Description

• Oversee and manage daily procedural schedules within the hospital to determine pre-authorization requirements.

• Acquire authorizations from insurance providers through telephone, fax, and online platforms.

• Ensure that CPT and ICD-10 codes correspond with scheduled procedures and meet insurance criteria.

• Collaborate with healthcare providers to address peer-to-peer requests and challenge denied authorizations.

• Inform patients regarding procedure approvals, rescheduling, or cancellations.

• Review medical charts to confirm that procedures align with the plans set by providers.

• Work in close coordination with hospital pre-service teams to verify that all authorizations are both accurate and complete.

• Stay informed about insurance guidelines and ensure adherence to all HIPAA regulations.

⛳️ Requirements

• High School Diploma or GED.

• 1-3 years of experience in medical authorization, healthcare administration, or a similar field.

• Strong grasp of medical terminology and insurance guidelines.

• Exceptional attention to detail and organizational capabilities.

• Familiarity with ICD-10 and CPT coding.

• Previous experience with pre-authorizations or appeals processes.

• Proficiency in using healthcare systems such as EPIC or other EMR platforms.

🏝️ Benefits

• Comprehensive health insurance (with no-cost premiums).

• Dental and vision plans.

• Flexible Spending Account (FSA) / Health Savings Account (HSA) options.

• Retirement matching.

• Paid vacation and floating holidays.

• Mental health support.