Prior Authorization Specialist

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

📋 Description

• Accurately and efficiently process assigned Care Coordination Services / Health Information Management tasks in accordance with client protocols.

• Assess medical documents and electronically file them into patient records.

• Utilize client EHR software and internal systems effectively.

• Handle high workloads while ensuring quality and precision.

• Conduct data entry and typing tasks.

• Engage in cross-training across multiple EHRs to ensure team coverage.

• Adhere to established filing procedures and seek guidance when necessary.

• Implement assigned client protocols and Service Level Agreements.

• Monitor and record completed work, time, and transaction counts.

• Achieve client Planning Guidelines or Target Transactions per Hour.

• Fulfill tasks assigned by management.

• Communicate any variances, issues causing delays, and corrective measures to management.

• Review and reference internal documentation and protocols.

• Uphold confidentiality and report any HIPAA violations.

• Deliver customer service to customers, vendors, visitors, coworkers, and management.

• Participate in required meetings and training sessions.

• Perform additional duties to support departmental and company operations.

⛳️ Requirements

• A High School Diploma or equivalent is mandatory.

• Experience with health information management concepts, EHRs, and/or medical terminology is advantageous.

• Proven ability to manage a high-volume, fast-paced environment with accuracy.

• Intermediate computer skills, including proficiency in Microsoft Office Suite and adaptability to company-specific software.

• Capable of efficiently navigating multiple open programs, windows, and applications.

• Exceptional attention to detail and accuracy.

• Ability to perform physical tasks such as sitting, talking, hearing, using hands, reaching, standing, walking, driving, and occasionally lifting up to 25 lbs.

• Willingness to work occasional after-hours or weekends as needed.

• Capacity to fulfill responsibilities in a remote setting while ensuring access to reliable internet within a designated, secure, and private workspace.

• Must adhere to HIPAA guidelines and procedures.

• Compliance with company/client agreed compliance standards is required.

• Responsibility for protecting sensitive data is essential.

🏝️ Benefits

• This role may be performed onsite, in a hybrid format, or entirely remote, allowing you to work from your home office.

• Occasional after-hours or weekend work may be required.