Prior Authorization Specialist

Job Description

The Prior Authorization Specialist (Financial Clearance I) at our healthcare client will ensure all required pre-certifications and prior authorizations are obtained for scheduled outpatient services prior to the date of service, in accordance with payer and hospital requirements.

We are a company committed to creating diverse and inclusive environments where people can bring their full, authentic selves to work every day. We are an equal opportunity/affirmative action employer that believes everyone matters. Qualified candidates will receive consideration for employment regardless of their race, color, ethnicity, religion, sex (including pregnancy), sexual orientation, gender identity and expression, marital status, national origin, ancestry, genetic factors, age, disability, protected veteran status, military or uniformed service member status, or any other status or characteristic protected by applicable laws, regulations, and ordinances. If you need assistance and/or a reasonable accommodation due to a disability during the application or recruiting process, please send a request to [email protected] learn more about how we collect, keep, and process your private information, please review Insight Global's Workforce Privacy Policy:

Skills and Requirements

• High School Diploma or GED Equivalent

• 2+ years of Prior Authorization Verification Experience

• 2+ years of experience in pre-certification initiation in a healthcare/ health office setting

• Prior insurance experience

• Hands-on experience with insurance portals, including:

• Availity, Carelon, Telligent (HMO referrals and authorizations)

• Demonstrates knowledge of Utilization Management Process

• Medicare/Medicaid experience and knowledge

• Clinical knowledge and understanding of medical services

• Epic experience (ask what tools they used)

• Experience supporting HMO and PPO plans

• Tech Savvy - Proficient in Microsoft Office (Teams specifically)

• Excellent communication and verbal skills

• Eagerness to learn and grow within a company, likes overtime, hardworking - Bachelor's degree