Health Information Specialist (Prior Authorization)

Pacific Neuropsychiatric Specialists; Irvine (CA); On-site; USD 34,440,000 - 48,216,000; Full time

Job summary

Pacific Neuropsychiatric Specialists is seeking an Authorization Specialist to manage prior authorizations and insurance requests in a fast-paced clinical setting. You will gather documents, submit forms, track status, and ensure timely approvals while maintaining accurate medical records in the EMR.

You will collaborate across departments, prioritize competing tasks, and communicate clearly with insurers and staff to support patient care and compliance.

Qualifications

• Previous experience working in a medical/psychiatric facility is preferred.
• Medical Records and Prior Authorization experience preferred, but not required.

Responsibilities

• Submitting requests to insurance companies, gathering necessary documents, completing forms and following up on the status of the requests.
• Provide updates on the authorization, review requests for completeness and ensure all supporting documents are submitted to expedite approvals.
• Receive requests for prior authorizations and ensure that they are monitored within company-set standards.
• Review the accuracy and completeness of the information requested and ensure that all supporting documents are present.
• Assist with medical necessity documentation to expedite approvals and ensure follow-up is completed.
• Collaborate with other departments to assist in obtaining prior authorizations/appeals.
• Document all interactions with insurance companies within the EMR system.
• Proactively work on prior authorizations that are due to expire.
• Completes all required duties, projects, and reports in a timely fashion per leadership.
• Other duties as assigned

Skills

Medical Records and Prior Authorizatio

Excellent communication skills

Proficient telephone and computer

Prioritize multiple tasks

Professional interaction with staff

Job description

Key Responsibilities:

• Submitting requests to insurance companies, gathering necessary documents, completing forms and following up on the status of the requests.
• Provide updates on the authorization, review requests for completeness and ensure all supporting documents are submitted to expedite approvals.
• Receive requests for prior authorizations and ensure that they are properly and closely monitored within company-set standards.
• Review the accuracy and completeness of the information requested and ensure that all supporting documents are present.
• Assist with medical necessity documentation to expedite approvals and ensure that appropriate follow-up is completed.
• Collaborate with other departments to assist in obtaining prior authorizations/appeals.
• Document all interactions with insurance companies within the EMR system.
• Proactively work on prior authorizations that are due to expire.
• Completes all required duties, projects, and reports in a timely fashion on a daily, weekly, or monthly basis per the direction of the leadership.
• Other duties as assigned

Required Skills and Qualifications:

• Previous experience working in a medical/psychiatric facility is preferred.
• Excellent communication skills, both written and oral.
• Proficient telephone and computer skills.
• Must be able to prioritize multiple tasks at once, and deal with high stress levels in an environment of changing priorities.
• Must be able to interact with all levels of staffing professionally.
• Medical Records and Prior Authorization experience preferred, but not required.

Compensation and Benefits:

• PNS offers a competitive compensation package including; medical, dental, and paid time off for full time employees.
• Hourly rate based on skill, experience and tenure of your profession.