Remote Prior Authorization Specialist Payer Approvals

Solum Health (YC 22); Colombia; Remote; COP 127,409,000 - 222,965,000; Full time

Job summary

Solum Health (YC 22) is seeking a detail-driven Prior Authorization Specialist to join a remote Colombia-based team. You will build and submit authorization requests for U.S. facilities, track approvals, and ensure every submission is complete and timely to keep services moving.

The role requires hands-on experience with EHR systems and payer portals, bilingual English, and the discipline to manage high-volume authorizations, re-authorizations, and appeals. You’ll work U.S.

Qualifications

• 2–3 years managing prior authorizations for U.S. facilities (required).
• Experience in outpatient settings (speech therapy, occupational therapy, ABA, imaging or behavioral health).
• Hands-on experience with EHR systems (required).
• Direct experience working with U.S.-based companies and familiarity with the U.S. healthcare system (required).

Responsibilities

• Obtain authorizations end to end. Build and submit prior authorization requests, track them through the payer, follow up persistently, and confirm approval before services are delivered.
• Get the clinical story right. Gather and review the documentation payers require — clinical notes, CPT/ICD codes, medical necessity — and make sure each submission is complete and accurate the first time.
• Manage the full lifecycle. Track authorization status, expiration dates, units, and re-authorizations so nothing lapses and no care is delivered without coverage in place.
• Fight denials. Identify why requests are denied, prepare and submit appeals, and coordinate peer-to-peer reviews to overturn them.
• Own quality and outcomes. Review your own and the team's authorizations for accuracy, catch problems before they become denials or delays, and make sure approval-rate and turnaround targets are consistently met.
• Keep the EHR accurate. Enter and maintain authorization and patient information with precision. Current, error-free records are non-negotiable.
• Track and report. Use Excel (including pivot tables) to monitor authorization volume, approval rates, turnaround, and denials, and surface where things are slipping.

Skills

Bilingual English

Detail-oriented

Strong communication

High-volume work

Education

Bachelor's degree or Associate degree in healthcare administration

Tools

EHR systems

Availity

Payer/insurance portals

Job description

Solum Health (YC 22) is seeking a detail-driven Prior Authorization Specialist to join a remote Colombia-based team. You will build and submit authorization requests for U.S. facilities, track approvals, and ensure every submission is complete and timely to keep services moving.

The role requires hands-on experience with EHR systems and payer portals, bilingual English, and the discipline to manage high-volume authorizations, re-authorizations, and appeals. You’ll work U.S.