Authorization Specialist

• Monitor authorizations for upcoming surgical cases on physicians’ calendars
• Ensure surgery authorizations are obtained accurately and on time
• Verify patient demographic information and insurance eligibility, including coordination of benefits
• Update and confirm information needed for claims processing
• Complete surgical cost analysis forms and document required cost estimates for collection before services
• Verify benefits for all surgical procedures
• Document authorization status and progress in patient charts and case management
• Provide ongoing staff training and education regarding new processes
• Work with the department manager to respond to and reduce complaints
• Assist surgery schedulers with STAT authorizations
• Identify opportunities to improve daily workflow processes
• Attend department meetings as required
• Communicate with physicians, patients, coworkers, management, providers, and internal and external customers

Surgical Authorization Specialist

• Monitor authorizations of upcoming surgical cases on physicians’ calendars
• Ensure surgery authorizations are obtained accurately and on time
• Verify patient demographics, insurance eligibility, and coordination of benefits
• Update information needed for claims processing
• Complete surgical cost analysis forms and document cost estimates for collection before services
• Verify benefits for surgical procedures
• Document authorization progress in patient charts and case management
• Provide ongoing staff training and education on new processes
• Work with the department manager to address and reduce complaints
• Assist surgery schedulers with STAT authorizations
• Maintain confidentiality of health records and member information in accordance with HIPAA
• Identify workflow improvement opportunities
• Attend department meetings as required

• Ensure accuracy of insurance information and obtain prior authorization and predetermination requirements for non-oncology infusions, oncology infusions, and radiation oncology
• Monitor patient, referral, and denial work queues to identify encounters requiring pre-registration, verification, authorization, or corrections
• Process encounters according to assignment and meet daily and weekly productivity goals
• Evaluate physician orders and pre-screen for medical necessity
• Review treatment plan frequency and duration and communicate with ordering providers or clinical staff regarding order revisions
• Review clinical documentation for CPT and diagnosis codes supporting authorization and precertification according to payer guidelines
• Monitor, review, and process authorizations for accuracy, timeliness, and insurance-guideline compliance
• Consult with pharmacy team members regarding provider-ordered drugs, payer preferences, authorization codes, and treatment-regimen appropriateness under NCCN and payer guidelines
• Coordinate with patients, referring physician offices, referring locations, scheduled service areas, financial counselors, case managers, and others to obtain or provide information
• Document pertinent information and efforts in the computer system according to department standards
• Protect the privacy and security of patient health information
• Work directly with patients, customers, healthcare professionals, and staff by telephone or face-to-face interaction

Authorization Specialist – II

• Submit initial authorization requests to assigned payers using paper forms, printed documentation, fax, payer portals, or other means
• Follow up on requests to ensure timely turnaround and approval
• Understand payer requirements to ensure approval is granted
• Escalate problem accounts and ensure resolution
• Maintain regular contact with patients, insurance plans, physician offices, sales representatives, and other personnel
• Submit authorization requests to insurance payers for Home Infusion Therapy
• Oversee follow-up on pending authorizations
• Review authorization approvals and denials for accuracy and initiate the appeal process
• Document calls, faxes, and email communications in CPR+ according to department SOP
• Maintain records of approved and denied authorizations in patients’ charts
• Share insurance updates and communications with management and team members
• Perform other duties assigned by the Intake Manager

• Act as a resource and support the prior authorization request process to ensure requests are addressed properly within contractual timelines
• Support the utilization management team with documentation and tracking of authorization requests and referrals
• Research and document medical information, including history, diagnosis and prognosis, for clinical reviewer determination
• Verify member insurance coverage and service/benefit eligibility using system tools
• Align authorizations with guidelines to support timely payment adjudication
• Perform data entry to maintain and update authorization requests in the utilization management system
• Process authorization requests according to the insurance prior authorization list and route them to appropriate clinical reviewers
• Remain up to date on healthcare authorization processes, policies and procedures
• Perform other duties as assigned
• Comply with all policies and standards

Authorization Specialist II

• Monitor patient, referral, and denial work queues to identify encounters requiring pre-registration, verification, authorization, or corrections
• Work encounters according to assignment while meeting daily and weekly productivity goals
• Evaluate physician referral and authorization requirements and ensure requirements are met before procedures
• Review clinical documentation for CPT and diagnosis code information supporting authorization/precertification
• Monitor, review, and process authorizations in accordance with timelines and insurance guidelines
• Coordinate with departments and ancillary areas for special needs or resources
• Counsel clinical partners and patients to obtain additional payer-required information
• Coordinate with patients, referring physician offices, referring locations, scheduled service areas, financial counselors, case managers, and others
• Document pertinent information and efforts in the computer system
• Protect the privacy and security of patient health information
• Work independently and make minor decisions in a complex technical or professional field
• Work with patients, customers, healthcare professionals, and staff by telephone or face-to-face

• Submit accurate and timely authorization requests to insurance companies and payers.
• Ensure proper setup and maintenance of patient accounts in the system.
• Obtain and review clinical documentation to verify medical necessity.
• Communicate with healthcare providers to gather required information for authorizations.
• Verify insurance benefits and eligibility for services.
• Monitor authorization request status and follow up as needed.
• Ensure compliance with payer requirements and regulations.
• Utilize basic medical coding, diagnosis codes, and medical terminology in the authorization process.
• Maintain detailed records and documentation for all authorizations.
• Collaborate with billing and claims teams to resolve authorization-related issues.
• Perform other duties as assigned.

Labcorp is a global leader in laboratory services, providing the insights and answers that help healthcare providers, patients, researchers, pharmaceutical companies and health systems make confident decisions and improve outcomes. Through our unparalleled science, data, technology and laboratory network, we advance diagnostics, accelerate innovation and help address some of the world’s most important health challenges. As we shape the future of healthcare, we are leveraging advanced technologies, intelligent digital solutions and data-driven innovation across our operations to enhance how work gets done and deliver greater value to customers and patients. With our global scale and deep expertise, you’ll have the opportunity to do meaningful work, grow your career and make a real impact on people’s health around the world. Together, we’re improving health and improving lives.

Labcorp is a global leader in diagnostic testing and drug development solutions, helping healthcare providers, researchers, and patients make informed decisions that advance care. Join us in our mission to improve health and improve lives. 

Labcorp is seeking a REMOTE a Pre Authorization Specialist II to join our team!
Work Schedule: Monday – Friday; 8:00am-5:00pm EST

Responsibilities:

- Well-versed in pre-authorization processes and policies to respond clearly to high-volume billing tasks and inquiries

- Maintain appropriate response time in various communication platforms (Example: phone calls, chats, emails, portal inquiries, etc)

- Identify issues and suggest potential improvements

- Collaborate with your team and develop best practices to ensure we are providing the best service and experience to all customers 

- Maintain an assigned schedule, and be flexible with daily schedules when business needs change

- Examine incoming orders to ensure completeness and accuracy of required documentation for prior authorization

- Work directly with various vendors to ensure successful submissions of prior authorizations

- Monitor the status of prior authorization requests, follow up on pending cases, and initiate follow-ups, if necessary, to ensure timely approvals

- Stay informed about insurance policies and guidelines, ensuring that all prior authorization requests align with the necessary criteria

- Maintain accurate records of prior authorization requests, approvals, and denials. Enter relevant information into databases

- Participate in projects that extend beyond your day-to-day to stretch you to think outside the box

Minimum Qualifications: 

- High school diploma with 3 or more years of experience of relevant experience.   

Preferred Qualifications: 

- Associate degree or higher in Healthcare Administration, Business Administration, Health Information Management, or a healthcare-related field.

- 2 or more years of experience documenting healthcare authorization activities within authorization, billing, reimbursement, or revenue cycle management systems

- 2 or more years of experience working with Labcorp systems, including LCLS and/or LCBS.

- 2 or more years of experience in Revenue Cycle Management (RCM) operations.

- 1 or more years of experience using Microsoft Word, Excel, and Outlook in a healthcare, reimbursement, billing, or authorization environment.

Additional Job Standards: 

- Ability to work remotely from a private, quiet workspace

- Reliable high‑speed internet connection (minimum 50 Mbps)

- Proficiency with Microsoft Office (Word, Excel, Outlook)

- Strong customer service, time management, and organizational skills

- Excellent verbal and written communication abilities

- High attention to detail with the ability to manage multiple priorities

- Solid understanding of medical terminology, insurance guidelines, and healthcare regulations

- Self‑motivated, collaborative, and willing to take initiative to get work done

- Strong work ethic with flexibility and a commitment to supporting positive patient outcomes

- Enjoys problem‑solving in a fast‑paced, team‑oriented, and evolving environment

- Provide responsive, professional support to providers, patients, and insurance representatives regarding prior authorization status and requirements.

The Pre Authorization Specialist II supports reimbursement and revenue cycle activities by conducting benefit investigations, reviewing payer medical policies, initiating, and managing prior authorizations, and providing patient cost estimates. This role partners with patients, health plans, clients, and internal stakeholders to ensure required authorization and coverage requirements are met while maintaining accurate documentation and supporting timely billing and reimbursement processes. The position is a first-shift remote role with flexibility in scheduling based on business needs.

Application Window Closes: 9/22/2026

**Pay Range: $18.00 - $25.00
All job offers will be based on a candidate’s skills and prior relevant experience, applicable degrees/certifications, as well as internal equity and market data

Benefits: Employees regularly scheduled to work 20 or more hours per week are eligible for comprehensive benefits including: Medical, Dental, Vision, Life, STD/LTD, 401(k), Paid Time Off (PTO) or Flexible Time Off (FTO), Tuition Reimbursement and Employee Stock Purchase Plan. Employees regularly scheduled to work less than 20 hours, Casual, Intern, and Temporary employees are only eligible to participate in the 401(k) Plan. Employees who are regularly scheduled to work a 7 on/7 off schedule are eligible to receive all the foregoing benefits except PTO or FTO. For more detailed information, please click here. 

Labcorp is proud to be an Equal Opportunity Employer:
Labcorp strives for inclusion and belonging in the workforce and does not tolerate harassment or discrimination of any kind. We make employment decisions based on the needs of our business and the qualifications and merit of the individual. Qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, sex (including pregnancy, childbirth, or related medical conditions), family or parental status, marital, civil union or domestic partnership status, sexual orientation, gender identity, gender expression, personal appearance, age, veteran status, disability, genetic information, or any other legally protected characteristic. Additionally, all qualified applicants with arrest or conviction records will be considered for employment in accordance with applicable law. 

We encourage all to apply
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Pre Authorization Specialist II

• Develop relationships with Nurse Case Managers/Adjusters to provide top notch customer service experience
• Verify and obtain authorizations as required by insurance companies dependent upon plan coverage for all patients
• Accurately enter authorized dates, visits, or units into ATI’s Electronic Medical Records (EMR) to track therapy services
• Coordinate communication between insurance companies and the clinic regarding insurance-specific forms and timelines
• Provide feedback for authorization changes according to insurance plan changes
• Collaborate with the Central Billing Office regarding missed authorizations
• Handle the assigned authorization workload efficiently to ensure timely completion of requests
• Ensure compliance with departmental and company policies and procedures
• Complete all assigned training programs
• Collaborate with team members using supportive communication, respect, and appropriate feedback

• Submit accurate and timely authorization requests to insurance companies and payers.
• Set up and maintain patient accounts in the system.
• Obtain and review clinical documentation to verify medical necessity.
• Communicate with healthcare providers to gather required authorization information.
• Verify insurance benefits and eligibility for services.
• Monitor authorization request status and follow up as needed.
• Ensure compliance with payer requirements and regulations.
• Apply basic medical coding, diagnosis codes, and medical terminology in the authorization process.
• Maintain detailed records and documentation for all authorizations.
• Collaborate with billing and claims teams to resolve authorization-related issues.
• May perform other duties as assigned.