Pre Authorization Specialist II

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

📋 Description

• Address a high volume of billing tasks and inquiries while adhering to pre-authorization processes and policies.

• Ensure timely responses across various platforms including phone, chat, email, and portals.

• Recognize issues and propose potential enhancements.

• Collaborate with team members to develop and implement best practices.

• Adhere to an assigned schedule while being adaptable to evolving business needs.

• Review incoming orders for completeness and the accuracy of prior authorization documentation.

• Coordinate with vendors to successfully submit prior authorizations.

• Track prior authorization requests, follow up on outstanding cases, and initiate additional follow-ups as necessary.

• Stay updated on insurance policies and guidelines.

• Keep precise records of authorization requests, approvals, and denials in databases.

• Engage in projects beyond regular daily responsibilities.

• Provide prompt and professional support to providers, patients, and insurance representatives.

• Conduct benefit investigations, review payer medical policies, initiate and manage prior authorizations, and offer patient cost estimates.

• Collaborate with patients, health plans, clients, and internal stakeholders to satisfy authorization and coverage criteria.

• Facilitate timely billing and reimbursement processes.

⛳️ Requirements

• High school diploma with a minimum of 3 years of relevant experience.

• Associate degree or higher in Healthcare Administration, Business Administration, Health Information Management, or a related healthcare field (preferred).

• At least 2 years of experience documenting healthcare authorization activities within authorization, billing, reimbursement, or revenue cycle management systems (preferred).

• A minimum of 2 years of experience working with Labcorp systems, including LCLS and/or LCBS (preferred).

• At least 2 years of experience in Revenue Cycle Management (RCM) operations (preferred).

• One or more years of experience using Microsoft Word, Excel, and Outlook in a healthcare, reimbursement, billing, or authorization context (preferred).

• Capability to work remotely from a private and quiet workspace.

• Reliable high-speed internet connection (minimum of 50 Mbps).

• Proficiency in Microsoft Office (Word, Excel, Outlook).

• Strong skills in customer service, time management, and organization.

• Excellent verbal and written communication skills.

• High attention to detail with the ability to manage multiple priorities effectively.

• Solid understanding of medical terminology, insurance guidelines, and healthcare regulations.

• Self-driven, collaborative, and proactive in taking initiative.

• Strong work ethic, adaptability, and dedication to supporting positive patient outcomes.

• Problem-solving skills in a fast-paced, team-oriented, and dynamic environment.

🏝️ Benefits

• Medical insurance.

• Dental insurance.

• Vision insurance.

• Life insurance.

• Short-term disability (STD).

• Long-term disability (LTD).

• 401(k) plan.

• Paid Time Off (PTO) or Flexible Time Off (FTO).

• Tuition reimbursement.

• Employee Stock Purchase Plan.