Prior Authorization Specialist

Job Summary

A company is looking for a Specialist I, Prior Authorization to join their Prior Authorization department.

Key Responsibilities

• Review, process, and troubleshoot incoming Prior Authorization requests for medications
• Communicate prior authorization criteria and assist providers in submitting requests
• Maintain compliance with regulatory guidelines and participate in departmental projects

Required Qualifications

• High school degree or equivalent; post high school education in relevant fields is desired
• Previous customer service experience is required
• Data entry experience is preferred
• Experience in health insurance or managed care is preferred
• Prior authorization processing experience is desired