Prior Authorization Specialist

oumedicine; United States; On-site; USD 50,000 - 70,000; Full time

Benefits offered by this job

PTO

401(k)

Medical and dental plans

Job summary

OU Health is seeking a Prior Authorization Specialist I to join the Pre-visit Services team in Oklahoma. Under general supervision, you will complete prior authorization workflows using payer rules and Epic.

The role may require years of experience depending on level, with CHAA or PACS within one year. This is a full-time, on-site role with monthly on-site needs and a Mon–Fri day shift.

Qualifications

• High School Diploma or GED required.
• CHAA or PACS required after 1 year.
• CHAA or PACS required.

Responsibilities

• Submit prior authorization requests using standard payer workflows.
• Verify basic benefits, coverage, and authorization requirements.
• Track authorization status and update Epic accurately.
• Escalate incomplete or non-standard cases per protocol.
• Collaborate with departments across the organization.

Skills

Attention to detail

Communication skills

Workflow adherence

Epic experience

Payer concepts

Education

High School Diploma or GED

Tools

Epic

Payer portals

Claims workflows

Job description

Position Title:

Prior Authorization Specialist

Department:

Pre-visit Services

Remote Eligibility:

Candidates must reside and work full-time in OK before their first day of employment.

SHIFT:

M-F, Days. Will need to be on-site as needed, at least monthly.

Ideal candidate will have experience in pre-visit services for multiple areas, working with authorizations.

General Description

Under general supervision, the Prior Authorization Specialist I complete prior authorization workflows using defined protocols, system and payer rules.

Essential Job Duties

• Submit prior authorization requests using standard payer workflows.
• Verify basic benefits, coverage, and authorization requirements.
• Track authorization status and update Epic accurately.
• Escalate incomplete or non-standard cases per protocol.
• Collaborate with departments across the organization.

General Job Duties

Performs other duties as assigned

Minimum Requirements (Level 1)

• Education : High School Diploma or GED required.
• Certification/License/Registration: None required.
• Experience: No experience required.

Minimum Requirements (Level 2)

• Education: High School Diploma or GED required.
• Experience: At least 3 years of prior authorization experience required.
• Certification/License/Registration: CHAA or PACS required after 1 year.

Minimum Requirements (Level 3)

• Education : High School Diploma or GED required.
• Experience: At least 5 years of prior authorization experience required.
• Certification/License/Registration : CHAA or PACS required.

Knowledge, Skills & Abilities

• Foundational understanding of payer types and referral/authorization concepts.
• Ability to follow standardized workflows and documentation requirements.
• Developing proficiency in Epic and payer portals.
• Accuracy, timeliness, and compliance focus.
• Good written and verbal communication skills

#cb

OU Health is an equal opportunity employer. We offer a comprehensive benefits package, including PTO, 401(k), medical and dental plans, and many more. We know that a total benefits and compensation package, designed to meet your specific needs both inside and outside of the work environment, create peace of mind for you and your family.