Prior Authorization Specialist - Remote

Overview

MedCore Solutions is seeking a skilled Prior Authorization Specialist to join our growing team, responsible for obtaining prior authorizations for various medical services and medications.

In Short

• Review and process prior authorization requests for medical services, procedures, and medications.
• Verify insurance (pharmacy) information and eligibility.
• Handle patient inquiries regarding authorizations.
• Provide necessary prior authorization documentation to patients.
• Accurately document all patient, pharmacy, and insurance carrier interactions in EMR.
• Coordinate with healthcare providers and insurance companies.
• Ensure accurate and timely documentation of authorization requests.
• Collaborate with medical billing team to resolve issues or denials.
• Maintain up-to-date knowledge of insurance guidelines.
• Assist with notifying patients of pathology results.

Requirements

• Experience in prior authorization or healthcare.
• Strong communication skills.
• Knowledge of insurance processes.
• Ability to work in a fast-paced environment.
• Proficiency in EMR/EHR systems.

Benefits

• Work from home flexibility.
• Full-time schedule with weekends off.
• Opportunity to work in a growing healthcare division.