Prior Authorization Specialist

January 10, 2025
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Now hiring for a Prior Authorization Specialist.

Responsibilities:

  • Identify appropriate prior authorization paperwork to file based on MCE
  • Complete prior authorization paperwork and submit to appropriate MCE
  • Gather necessary Clinical Documentation (Assessment and Treatment Plan for Initial prior authorization, progress notes for redetermination)
  • Ensure timely communication and follow-up with the Clinical Team and Supervisors to secure necessary documentation for submission and appeal of authorizations and denials
  • Ensure timely filing of prior authorization with appropriate MCEs upon intake and delivery of services
  • Calling MCEs to follow up on prior authorization and provide additional documentation or info to MCEs as needed

Qualifications:

  • Analytical mindset and organization are required 
  • The ability to multi-task is required
  • Comfortable working in a team environment is required
  • Must be organized and able to work in a fast-paced environment.
  • Must know what payors are
  • Must know what procedure codes are and the authorization process

This position is remote, but requires the person to reside in Indiana.

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