Prior Authorization Specialist

CorroHealth

. Determine whether payer authorization is required for pre-registered outpatient diagnostic and surgical services .

Posted 10/9/2026full-timeRemote • United StatesMid-LevelSeniorWebsite

Core Competencies

Role fit

Core Competencies

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

Demonstrates expertise in payer authorization processes and medical necessity checks while ensuring compliance with HIPAA standards. Proficient in managing multiple priorities in a remote environment and effectively communicating with patients and healthcare providers.

Highest-signal resume keywords

Healthcare ExperienceMedical Terminology FamiliarityPrior Authorization Processes KnowledgeRevenue Cycle Process KnowledgeBasic Computer Skills

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Payer Authorization DeterminationMedical Necessity CheckClinical Data SubmissionClaim Resolution RequirementsPatient Outreach Compliance

Soft Skills

Ability to Handle Multiple PrioritiesEffective CommunicationTimeliness of Deliverables

Tools & Technologies

Insurance Carrier Websites

Certifications & Qualifications

High School DiplomaGED Equivalent

Industry Keywords

HIPAA CompliancePatient Satisfaction StandardsOutpatient Diagnostic ServicesSurgical Services

About the role

Key responsibilities & impact

Determine whether payer authorization is required for pre-registered outpatient diagnostic and surgical services
Escalate cases without authorization or referral to the scheduling physician for approval or clinical data
Submit authorization requests by phone or online to obtain approval for requested services
Gather and submit clinical data requested by insurance companies
Complete the first-pass medical necessity check when needed
Follow up with physician offices to obtain additional diagnoses and revised scripts when the medical necessity check fails
Follow up with patients when needed
Follow client scripting guidelines for patient and physician outreach in compliance with HIPAA and patient satisfaction standards
Meet or exceed productivity guidelines
Perform other duties as assigned

Requirements

What you’ll need

High School Diploma or GED equivalent
Healthcare experience and familiarity with medical terminology
Knowledge of multiple specialty and prior authorization processes preferred
Knowledge of revenue cycle process
Ability to handle multiple priorities to ensure timeliness of all deliverables
Basic computer skills
Familiarity with insurance carrier websites and processes, including claim resolution requirements
Ability to work effectively in a remote environment
Regular eye-hand coordination and manual dexterity
Ability to perform work at a computer terminal for 6–8 hours a day
Ability to function in an environment with constant interruptions
Ability to sit for prolonged periods
Ability to lift and move material weighing up to 20 lbs. infrequently

Benefits

Comp & perks

Professional development and personal growth opportunities
Remote work arrangement