Prior Authorization Specialist

Assist Point Inc; Allen (TX); On-site; USD 42,000 - 62,000; Full time

Job summary

Assist Point Inc in Allen, TX is seeking a detail-oriented Prior Authorization Specialist to manage and process authorization requests for medical services and medications.

You will review requests, communicate with insurers, verify coverage, maintain records, and collaborate with providers and patients to resolve issues while ensuring regulatory compliance.

Qualifications

• High school diploma or equivalent required; Associate’s or Bachelor’s degree preferred.
• Previous experience in prior authorization, medical billing, or healthcare administration is a plus.
• Strong knowledge of insurance plans, medical terminology, and healthcare regulations.
• Excellent communication and interpersonal skills.
• Ability to work independently and manage multiple tasks efficiently.
• Proficient in using electronic medical records (EMR) systems and Microsoft Office Suite.

Responsibilities

• Review and process prior authorization requests submitted by healthcare providers.
• Communicate with insurance companies to obtain necessary approvals for medical procedures, treatments, and medications.
• Verify patient insurance coverage and eligibility.
• Maintain accurate and up-to-date records of all prior authorization activities.
• Collaborate with healthcare providers, patients, and insurance representatives to resolve any issues or denials.
• Ensure compliance with all regulatory and organizational policies related to prior authorizations.
• Provide timely updates to patients and providers regarding the status of their authorization requests.

Skills

Communication skills

Interpersonal skills

Independent work

Multi-tasking

EMR systems

Microsoft Office

Insurance plans knowledge

Medical terminology

Healthcare regulations

Education

High school diploma or equivalent

Associate’s degree

Bachelor’s degree

Tools

EMR software

Microsoft Office Suite

Job description

We are seeking a detail-oriented and organized Prior Authorization Specialist to join our team in Allen, TX. The ideal candidate will be responsible for managing and processing prior authorization requests to ensure timely approval of medical services and medications for our patients.

Responsibilities

• Review and process prior authorization requests submitted by healthcare providers.
• Communicate with insurance companies to obtain necessary approvals for medical procedures, treatments, and medications.
• Verify patient insurance coverage and eligibility.
• Maintain accurate and up-to-date records of all prior authorization activities.
• Collaborate with healthcare providers, patients, and insurance representatives to resolve any issues or denials.
• Ensure compliance with all regulatory and organizational policies related to prior authorizations.
• Provide timely updates to patients and providers regarding the status of their authorization requests.

Qualifications

• High school diploma or equivalent; Associate’s or Bachelor’s degree preferred.
• Previous experience in prior authorization, medical billing, or healthcare administration is a plus.
• Strong knowledge of insurance plans, medical terminology, and healthcare regulations.
• Excellent communication and interpersonal skills.
• Ability to work independently and manage multiple tasks efficiently.
• Proficient in using electronic medical records (EMR) systems and Microsoft Office Suite.