Prior Authorization Specialist

• Manage the end-to-end prior authorization process for healthcare practitioners.
• Submit, track, and follow up on prior authorization requests.
• Manage inbound and outbound calls with healthcare insurance companies to verify authorization requirements, check status updates, and resolve pending or denied requests.
• Verify patient healthcare insurance coverage, benefits, and plan requirements before scheduling procedures or submitting authorizations.
• Retrieve relevant medical history, clinical notes, and diagnostic reports.
• Act as the primary point of contact between medical providers, patients, and payors.
• Identify reasons for authorization denials, gather missing clinical information, and prepare basic appeal packages under healthcare provider direction.
• Provide back-office support including data entry, email management, authorization tracking log maintenance, and record management.
• Ensure timely approvals for procedures, medications, diagnostic testing, and specialist referrals.
• Support patient care access, practice workflow, and revenue cycle efficiency.

Explore Medical VA – Prior Authorization Specialist at Global Medical VA Careers. Review requirements and application details.