Care Access & Authorization Specialist

Raleigh Medical Group; United States; Remote; USD 42,000 - 60,000; Full time

Benefits offered by this job

Group Health, Dental, Vision

FSA/HSA options

Generous PTO

401(k) with employer matching

Company-paid Life/Disability

Competitive pay

Job summary

Raleigh Medical Group, PA is seeking an Authorization Specialist to support timely and accurate prior authorizations for medications, diagnostic procedures, and specialty services across the organization. This role helps ensure patients receive access to care without delays while communicating with patients, providers, pharmacies, and insurance companies.

The Authorization Specialist works with clinical and administrative teams to verify insurance requirements, monitor authorization status, and

Qualifications

• Minimum 1 year of medical office and EHR experience.
• Strong communication, organization, and customer service skills.
• Attention to detail and ability to prioritize tasks effectively.
• Ability to work independently with minimal supervision.

Responsibilities

• Obtain prior authorizations and pre-certifications for medications, procedures, and specialty services.
• Verify insurance benefits and identify authorization requirements as needed.
• Monitor authorization status and follow up to prevent delays in patient care.
• Communicate with patients, providers, pharmacies, and insurance companies regarding authorization requirements and updates.
• Accurately document authorization and benefit information in the EHR and practice management system.
• Maintain current knowledge of payer guidelines and authorization processes.
• Collaborate with clinical and front office staff to coordinate patient care efficiently.
• Communicate workflow updates and payer changes to appropriate team members.
• Participate in departmental meetings and training sessions.
• Assist with onboarding and cross-training of team members as requested.
• Maintain compliance with HIPAA regulations and safeguard PHI.

Job description

Raleigh Medical Group, PA is seeking an Authorization Specialist to support timely and accurate prior authorizations for medications, diagnostic procedures, and specialty services across the organization. This role helps ensure patients receive access to care without delays while communicating with patients, providers, pharmacies, and insurance companies.

The Authorization Specialist works with clinical and administrative teams to verify insurance requirements, monitor authorization status, and