Pre-Authorization Specialist – Insurance Portal Experience

Carle Health

. Identify prior authorization requirements by insurance/payer .

Posted 10/13/2026full-timeRemote • Illinois • United StatesMid-LevelSenior💰 $18 - $29 per hourWebsite

Core Competencies

Role fit

Core Competencies

Use this summary to align your resume positioning with the role.

Demonstrates proficiency in processing prior authorizations and utilizing insurance portals, with a strong focus on communication and collaboration with healthcare providers. Maintains confidentiality and professionalism while managing time-sensitive tasks in a fast-paced environment.

Highest-signal resume keywords

Prior Authorization ProcessingInsurance Portal ExperienceEpic DocumentationCommunication SkillsCustomer Interaction

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Prior Authorization RequirementsInsurance Coverage DeterminationThird Party Payer PortalsBasic Computer KnowledgeWord ProcessingSpreadsheetsEmail ApplicationsWeb Browsers

Soft Skills

Professional DemeanorInterpersonal SkillsConfidentiality MaintenanceAppropriate Response to Customers

Tools & Technologies

Epic

Certifications & Qualifications

High School DiplomaGED

Industry Keywords

Insurance ProvidersAuthorization Approval ExpectationsPeer-to-Peer Reviews

About the role

Key responsibilities & impact

Identify prior authorization requirements by insurance/payer
Process and complete prior authorizations for scheduled and add-on services
Determine whether services are covered benefits
Document pre-authorization information and results in Epic
Communicate approvals or denials to ordering provider offices, leadership, providers, and nurses
Process pre-authorizations in a time-sensitive manner to reduce denials
Collaborate with physicians and nurses to secure clinical information for submissions
Facilitate peer-to-peer reviews when needed
Identify challenges, trends, and patterns and work with management to resolve them
Perform other duties as assigned

Requirements

What you’ll need

Highschool Diploma or GED
Direct insurance portal experience
Proficiency utilizing third party payer/insurance portals for pre-authorization submissions
Detailed knowledge of insurance providers, their portals, and authorization approval expectations
Basic English reading skills
Basic English writing skills
Basic English oral skills
Ability to respond appropriately to customers and co-workers
Ability to interact with a wide variety of people
Ability to maintain confidential information
Ability to communicate only facts to recipients or decline to reveal information
Ability to project a professional, friendly, helpful demeanor
Basic computer knowledge, including word processing, spreadsheets, email applications, and web browsers
Comfortable with Windows OS and learning new applications
Ability to work Monday-Friday, 8:00 a.m.-5:00 p.m. Central

Benefits

Comp & perks

Comprehensive benefits package
Equal Opportunity Employer
E-Verify participation