Prior Authorization Specialist

MaineHealth; Conway (NH); On-site; USD 40,000 - 70,000; Full time

Job summary

An established industry player in healthcare is seeking a Prior Authorization Specialist to join their team. This role involves verifying insurance eligibility and benefits, as well as researching denied services to ensure timely payment processing. The ideal candidate will have experience in medical assisting or patient service representation, along with a solid understanding of medical terminology and insurance processes. Join a supportive environment that values teamwork and excellence in care, while benefiting from flexible work policies and resources for personal well-being.

Benefits

Paid Parental Leave

Flexible Work Policies

Student Loan Assistance

Training and Education Resources

Well-being Resources

Qualifications

• Experience in medical assisting or patient service representation is required.
• Knowledge of medical billing is essential.

Responsibilities

• Verify insurance eligibility and benefits for patients.
• Research denied services to ensure prompt payment processing.

Skills

Medical Terminology

Medical Insurance Knowledge

Referral/Pre-Authorization Understanding

Education

High School Diploma or GED

Job description

Description

Memorial Hospital

Clerical/Administrative Support

Req #: 32159

Summary:

The Prior Authorization Specialist verifies insurance eligibility, benefits, authorization, and researches denied services to ensure payments are processed promptly.

Required Minimum Knowledge, Skills, and Abilities (KSAs):

1. Education: High school diploma or GED preferred.
2. License/Certifications: N/A
3. Experience: Medical Assistant, Patient Service Representative, or medical billing experience required.
4. Additional Skills/Requirements: N/A
5. Preferred Skills: Medical Terminology, knowledge of Medical Insurance, and understanding of referrals/pre-authorizations.

Additional Information:

Join MaineHealth and work with healthcare professionals committed to valuing both their colleagues and the communities they serve across Maine and New Hampshire.

We offer benefits supporting your current needs and future planning, including paid parental leave, flexible work policies, student loan assistance, training, education, and well-being resources for you and your family.

MaineHealth is dedicated to investing in our care team and fostering an inclusive environment where you can thrive and reach your full potential. If you're interested in building a career in a supportive setting that emphasizes teamwork and excellence in care, apply today.

If you have questions about this role, please contact Connor H. Lemay at [e-mail].