[Remote] Authorization Specialist II
Note: The job is a remote job and is open to candidates in USA. RemoteHunter is connecting exceptional candidates with leading employers, and they are seeking an Authorization Specialist II. This role supports the Medical Management/Health Services team by managing prior authorization requests to ensure timely processing within contractual timelines.
Responsibilities
- Support prior authorization request process and ensure timely handling
- Document and track authorizations and referrals according to policies
- Research and provide medical information such as history, diagnosis, and prognosis for clinical review
- Verify member insurance coverage and service eligibility using system tools
- Enter and update authorization requests in the utilization management system
- Process authorization requests according to insurance prior authorization lists and route to clinical reviewers
- Stay current on healthcare authorization processes, policies, and procedures
- Perform other duties as assigned
- Comply with all policies and standards
Skills
- High School diploma or GED
- 1 to 2 years of related experience
- Knowledge of medical terminology and insurance
Benefits
- Health insurance
- 401K and stock purchase plans
- Tuition reimbursement
- Paid time off and holidays
- Flexible work options including remote, hybrid, field, or office schedules
Company Overview