Prior Authorization Specialist (Multi-Specialty) - Remote

Overview

We are looking for an experienced Prior Authorization Specialist with a strong background in Pulmonology, Gastroenterology, and Internal Medicine. The ideal candidate will be responsible for obtaining timely prior authorizations, verifying insurance coverage, and ensuring accurate documentation to support smooth patient care delivery. Experience with NextGen software is highly preferred.

In Short

• Process and track prior authorization requests for medications, procedures, and treatments.
• Verify patient insurance coverage, eligibility, and benefits.
• Collaborate with physicians, nurses, and insurance providers to obtain necessary approvals.
• Document and update all authorizations and communications in NextGen EMR.
• Identify and resolve prior authorization delays or denials in a timely manner.
• Maintain compliance with HIPAA and payer-specific guidelines.

Requirements

• Strong background in Pulmonology, Gastroenterology, and Internal Medicine.
• Experience with NextGen software.
• Excellent communication skills.
• Detail-oriented and organized.
• Ability to work collaboratively with healthcare professionals.

Benefits

• Permanent work-from-home position.
• Opportunity to work in a multi-specialty environment.
• Competitive salary and benefits package.
• Supportive team and work culture.