Prior Authorization Specialist | Contract | Remote

Davita Inc.; Louisville (KY); Remote; USD 40,000 - 60,000; Full time

Job summary

Davita Inc. is seeking a Prior Authorization Specialist to streamline the processing of authorization requests for treatments and medications. This role plays a crucial part in bridging communication between healthcare providers, patients, and insurance companies, ensuring timely care delivery. Applicants should possess strong attention to detail and excellent communication skills, supporting a diverse workplace.

Qualifications

• Experience in healthcare or insurance preferred.
• Familiarity with prior authorization processes.
• Ability to work independently and as part of a team.

Responsibilities

• Process prior authorization requests for medications and procedures.
• Verify patient insurance coverage and ensure compliance.
• Educate patients on authorization requirements.

Skills

Attention to Detail

Communication

Problem Solving

Education

High School Diploma

Tools

Epic software

Job description

Vaco has partnered with a company looking for prior authorization specialists to join their team!

Job Summary:
The Prior Authorization Specialist is responsible for processing prior authorization requests for medications, procedures, and treatments. This role involves coordinating with healthcare providers, insurance companies, and patients to ensure timely approvals, minimize delays, and support continuity of care.

Key Responsibilities:

• Review and process prior authorization requests for medications, procedures, and treatments.
• Verify patient insurance coverage and ensure compliance with payer guidelines.
• Communicate with healthcare providers to obtain necessary clinical documentation.
• Submit prior authorization requests to insurance companies and follow up on approvals or denials.
• Appeal denied authorizations by gathering supporting documentation and resubmitting requests.
• Maintain accurate records and documentation in electronic health records (EHR) and prior authorization software.
• Educate patients and providers on authorization requirements and approval timelines.
• Stay updated on insurance policies, formularies, and industry regulations.
• Collaborate with pharmacy staff, case managers, and billing teams to ensure smooth processing.
• Use of Epic software

Vaco by Highspring values a diverse workplace and strongly encourages women, people of color, LGBTQ+ individuals, people with disabilities, members of ethnic minorities, foreign-born residents, and veterans to apply.

EEO Notice

Vaco by Highspring is an Equal Opportunity Employer and does not discriminate against any employee or applicant for employment because of race (including but not limited to traits historically associated with race such as hair texture and hair style), color, sex (includes pregnancy or related conditions), religion or creed, national origin, citizenship, age, disability, status as a veteran, union membership, ethnicity, gender, gender identity, gender expression, sexual orientation, marital status, political affiliation, or any other protected characteristics as required by federal, state or local law.

Vaco by Highspring and its parents, affiliates, and subsidiaries are committed to the full inclusion of all qualified individuals. As part of this commitment, Vaco by Highspring and its parents, affiliates, and subsidiaries will ensure that persons with disabilities are provided reasonable accommodations. If reasonable accommodation is needed to participate in the job application or interview process, to perform essential job functions, and/or to receive other benefits and privileges of employment, please contact [e-mail] .

Vaco by Highspring also wants all applicants to know their rights that workplace discrimination is illegal.

By submitting to this position, you agree that you will be giving Vaco by Highspring the exclusive right to present your as a candidate for the foregoing employment opportunity. You further agree that you have represented information about yourself accurately and have not affirmatively misrepresented your qualifications. You also agree to maintain as confidential, to the fullest extent permitted by law, any information you learn from Vaco by Highspring about the position and you will limit disclosure of information about the position only to the extent necessary to perform any obligations in furtherance of your application. In exchange, Vaco by Highspring agrees to exercise reasonable efforts to represent you through all solicitation, job screening and resume dispersal.

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Vaco by Highspring and its parents, affiliates, and subsidiaries ("we," "our," or "Vaco by Highspring") respects your privacy and are committed to providing transparent notice of our policies.

• California residents may access Vaco by Highspring HR Notice at Collection for California Applicants and Employees here.
• Virginia residents may access our state specific policies here.
• Residents of all other states may access our policies here.
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Pay Transparency Notice

Determining compensation for this role (and others) at Vaco by Highspring depends upon a wide array of factors including but not limited to:

• the individual's skill sets, experience and training;
• licensure and certification requirements;
• office location and other geographic considerations;
• other business and organizational needs.

With that said, as required by local law, Vaco by Highspring believes that the following salary range referenced above reasonably estimates the base compensation for an individual hired into this position in geographies that require salary range disclosure. The individual may also be eligible for discretionary bonuses.