Prior Authorization Specialist — Epic & Denials Expert

Abbott Laboratories; Madison (WI); On-site; USD 31,000 - 62,000; Full time

Job summary

Abbott Laboratories is hiring for a Prior Authorization Associate Level I in Madison, WI. You will work cross-functionally across sales, operations, billing, and lab teams to determine patient eligibility and ensure proper authorization for reimbursement.

The role requires strong knowledge of prior authorization processes, experience with Epic, and adherence to HIPAA guidelines. This is a full-time position with standard daytime hours.

Qualifications

• 2+ years directly involved in submission and follow up of Prior Authorization workflows.
• 3 years of experience in medical billing, claims, and/or insurance processing.
• Extensive knowledge of government, managed care, and commercial insurance requirements.
• Knowledge of medical terminology and health insurance terms.

Responsibilities

• Independently determine initial or ongoing patient insurance eligibility verification and update patient demographics and guarantor information.
• Interact with various insurances to ensure authorization is obtained and documented per internal policies.
• Review and edit claims and appeals prior to submitting to clearinghouse.
• Analyze and resolve claim issues with a high degree of independence.
• Follow up with payors via phone on unpaid aging claims.
• Provide supporting documentation needed by insurance payors.

Skills

Prior authorization

Attention to detail

Communication skills

Teamwork

Education

High School Diploma or GED

Tools

Epic

Job description

Abbott Laboratories is hiring for a Prior Authorization Associate Level I in Madison, WI. You will work cross-functionally across sales, operations, billing, and lab teams to determine patient eligibility and ensure proper authorization for reimbursement.

The role requires strong knowledge of prior authorization processes, experience with Epic, and adherence to HIPAA guidelines. This is a full-time position with standard daytime hours.