Healthcare Authorization Specialist - Hybrid

Physical Rehabilitation Network, Inc.; Watauga (TX); Hybride; USD 28 000 - 30 000; Plein temps

Avantages offerts par ce poste

Medical benefits

Vision benefits

Dental benefits

Paid time off

Résumé du poste

Physical Rehabilitation Network, Inc. is hiring an Authorization Representative to obtain, verify, and document insurance authorizations for medical procedures.

This full-time hybrid role ensures compliance with payer requirements, helps prevent denials, and supports patient access to care by coordinating with providers, billing, and clinical teams. The ideal candidate has healthcare authorization experience, knowledge of CPT/ICD-10, and proficiency with EHR and payer portals, with strong

Qualifications

• High school diploma or equivalent.
• Experience in healthcare authorization, medical billing, patient access, or insurance verification.
• Strong understanding of medical terminology, CPT/ICD-10 codes, and insurance regulations.
• Excellent communication, organization, and problem-solving skills.
• Proficiency with EHR systems, payer portals, and standard office software.
• Experience working with multiple insurance payers (Medicare, Medicaid, commercial plans, etc.) preferred.

Responsabilités

• Secure prior authorizations and pre-certifications from insurance companies within required timeframes.
• Review medical necessity guidelines and payer policies to determine required documentation.
• Communicate with providers, clinical staff, and insurance carriers to obtain required details for authorization approval.
• Accurately document authorization numbers, effective dates, status updates, and payer information in EHR or practice management systems.
• Maintain organized and compliant records according to HIPAA standards.
• Provide updates to scheduling, billing, and clinical teams regarding authorization status.
• Collaborate with clinical teams to support appeals or additional documentation requests.
• Adhere to federal, state, and payer-specific regulations.
• Monitor policy changes from insurance carriers and notify internal teams as needed.
• Assist in resolving claim denials related to missing or incorrect authorizations.

Connaissances

Healthcare authorization

Medical terminology CPT/ICD-10

Communication skills

Organization skills

Problem-solving

EHR systems proficiency

Formation

High school diploma or equivalent

Outils

Payer portals

Office software

Description du poste

Physical Rehabilitation Network, Inc. is hiring an Authorization Representative to obtain, verify, and document insurance authorizations for medical procedures.

This full-time hybrid role ensures compliance with payer requirements, helps prevent denials, and supports patient access to care by coordinating with providers, billing, and clinical teams. The ideal candidate has healthcare authorization experience, knowledge of CPT/ICD-10, and proficiency with EHR and payer portals, with strong