Healthcare Prior Authorization Specialist

St. Francis Medical Center; United States; Remote; USD 42,000 - 60,000; Full time

Benefits offered by this job

Health coverage

Education assistance

Retirement benefits

ETO based on years of service

Job summary

Saint Francis Healthcare System is seeking an Authorization Specialist to review prior authorization requests for medical services, including surgeries and home health, in line with coverage guidelines. The role emphasizes independent problem solving, accurate documentation, and collaboration to keep authorizations moving smoothly.

You will support efficient workflows, maintain confidential information, and provide quality customer service across departments as part of Saint Francis Healthcare

Qualifications

• One year of experience in a healthcare setting obtaining insurance authorizations strongly preferred.
• Experience with CPT and ICD codes is a plus.

Responsibilities

• Review requests for prior authorization of medical services including elective and outpatient surgeries and procedures
• Determine benefit eligibility and document in accordance with guidelines
• Serve as liaison to create smooth workflows and transitions of information needed for authorizations
• Deliver quality customer service

Education

High school graduate or equivalent

Tools

CPT and ICD codes

Job description

Saint Francis Healthcare System is seeking an Authorization Specialist to review prior authorization requests for medical services, including surgeries and home health, in line with coverage guidelines. The role emphasizes independent problem solving, accurate documentation, and collaboration to keep authorizations moving smoothly.

You will support efficient workflows, maintain confidential information, and provide quality customer service across departments as part of Saint Francis Healthcare