Healthcare Authorization & Denials Specialist

UPMC; Pittsburgh (Allegheny County); On-site; USD 36,000 - 60,000; Full time

Job summary

University of Pittsburgh Physicians is hiring a full-time Authorization Specialist for the Heart and Vascular Institute at Children’s Hospital of Pittsburgh. The position is on-site Monday–Friday, 8:00am–4:30pm.

Prior experience in authorization and scheduling is required, with responsibilities spanning pre-authorizations, denials, and revenue-related duties. The role requires interaction with internal physicians, hospital divisions, and payors to ensure timely and compliant authorization and

Qualifications

• Experience in authorization activities including pre-authorizations, denials, and related scheduling tasks.

Responsibilities

• Prior authorization responsibilities: review records and determine medical necessity to pre-authorize procedures; ensure proper coding and timely submissions.
• General responsibilities: maintain compliance with quality standards and coordinate with physicians and payors to avoid delays and financial impact.
• Retrospective authorization responsibilities: resolve edits to ensure timely claim filing and minimize denials.

Skills

Authorization

Scheduling

Job description

University of Pittsburgh Physicians is hiring a full-time Authorization Specialist for the Heart and Vascular Institute at Children’s Hospital of Pittsburgh. The position is on-site Monday–Friday, 8:00am–4:30pm.

Prior experience in authorization and scheduling is required, with responsibilities spanning pre-authorizations, denials, and revenue-related duties. The role requires interaction with internal physicians, hospital divisions, and payors to ensure timely and compliant authorization and