Prior Authorization Specialist

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

📋 Description

• Process over 500 Medicaid Prior Authorization requests weekly while ensuring accuracy and compliance.

• Verify that PA requests adhere to Medicaid policies and procedures.

• Collaborate with the clinical team to guarantee timely and precise processing of PA requests.

• Communicate with Medicaid providers regarding the status and requirements of PA requests.

• Work closely with Gainwell and State personnel to ensure seamless authorization processing.

• Manage a high volume of work with minimal errors in a fast-paced, deadline-oriented environment.

• Provide exceptional customer service to Medicaid providers.

• Regularly interact with providers, clinical teams, and state employees.

• Utilize attention to detail and problem-solving skills in the authorization processing.

⛳️ Requirements

• Relevant experience in prior authorization processing, Medicaid policy, insurance, or pharmacy.

• Preferably possess strong knowledge of Medicaid policies and prior authorization procedures.

• Excellent written and verbal communication skills are essential.

• Strong customer service skills are required.

• Ability to multitask and effectively manage time.

• Capacity to meet strict deadlines in a remote work setting.

• Proficiency in Microsoft Office and PC-based applications is necessary.

• A typing speed of 50–60+ WPM is preferred.

• Strong attention to detail and problem-solving abilities are essential.

🏝️ Benefits

• Flexible hours.

• Work-life balance.

• Continuous learning and career development opportunities.

• Flexible vacation policy.

• 401(k) employer match.

• Comprehensive health benefits.

• Educational assistance.

• Leadership and technical development academies.

• Supportive team environment.