General Summary
The Prior Authorization Specialist coordinates and secures insurance authorization for medications, in-office injections, and imaging when needed to supportย timelyย patient care. This role involves reviewing payer requirements, gatheringย appropriate clinicalย documentation, and communicating with insurance companies, pharmacies, andย internalย staff toย facilitateย authorization approvals. The ideal candidateย demonstratesย strong time management, attention to detail, integrity, and the ability to manage multiple requests whileย maintainingย organization and professionalism in a high-volume environment.ย
Key Responsibilitiesย
Communicate professionally with insurance companies, pharmacies, patients, and internal staffย regardingย authorization requirements and status updates.ย
Physical Demands
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
While performing the duties of this job, the employee is occasionally required to stand; walk; sit; use hands to finger, handle, or feel objects, tools, or controls; reach with hands and arms; stoop, kneel, crouch, or crawl; and talk or hear.ย The employee must occasionally lift and/or move more than 45 pounds.
Excellent written and verbal communication skills when interacting with patients, insurance representatives, pharmacies, and internal clinical staff.ย
Demonstrates integrity, professionalism, and ethical decision-making when handling patient information andย submittingย prior authorization requests.ย
HS Diploma or GEDย required.ย