Job Description

This is a remote based position. Applicants can be located nationwide. Position Prior Authorization Specialist Responsibilities Collaborate with insurers to obtain pre-authorizations for condition-specific medications, diagnostic procedures and treatments, and support patients in navigating coverage and disputes. Submit prior authorization requests for medical procedures, diagnostic tests, treatments, and medications as required by insurance providers. Gather, review, and submit all necessary clinical documentation to support authorization requests, ensuring accuracy and completeness. Communicate with insurance representatives to clarify requirements, resolve authorization denials, and follow up on pending approvals. Collaborate with physicians, nurses, and other clinical staff to obtain additional clinical information or documentation required by insurance companies. Inform patients about the status of their authorization requests, answer questions regarding coverage, and provide guidance on next steps. Maintain accurate and detailed records of all prior authorization requests, outcomes, and patient information in compliance with HIPAA regulations. Stay updated on changes in insurance policies, state and federal regulations, and organizational policies affecting prior authorizations and reimbursement. Meet quality and productivity standards set by Signature and/or our client. Provide excellent customer service in keeping with Signature's legacy both internally and externally. Maintain expertise in multiple current client systems. Maintain up-to-date knowledge of revenue cycle management and industry trends, performing other duties as necessary. Act as an effective team member. Minimum Requirements Minimum of 2 years’ experience in EPIC EMR/HER. Minimum 2 years of prior authorization experience, insurance coordination, or case management within a physician office, hospital, or insurance plan authorization unit. Understanding of healthcare insurance systems. Strong written and verbal communication skills with the ability to explain complex medical and insurance information. Strong attention to detail. Passion for patient advocacy with a problem‑solving mindset, focusing on overcoming challenges to accessing care. Ability to work effectively both independently and as part of a multidisciplinary team. Computer proficiency including Microsoft Office, Word, Excel, and Outlook. Ability to function effectively in a fast‑paced environment. Personal traits of a high-level commitment, motivation, energy, team orientation, professionalism, trust, honesty, and integrity. Preferred Requirements Preferred experience and understanding of medical terminology. General knowledge of CPT/HCPCS and ICD‑10. Benefits Health Insurance Fully Paid Life Insurance Fully Paid Short‑ & Long‑Term Disability Paid Vacation Paid Sick Leave Paid Holidays Professional Development and Tuition Assistance Program 401(k) Program with Employer Match Security Requirements U.S. Citizenship, naturalized citizenship, or permanent status is required for this position. All work on this position must be completed in the continental United States, Alaska, or Hawaii. Work Schedule M-F, either 7:00 am to 3:30 pm or 8:00 am to 4:30 pm CST. Compensation $22‑$25 per hour. Position Type Full Time. #J-18808-Ljbffr

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