Prior Authorization Specialist: Fast-Track Approvals

Valid8 Financial, Inc.; Las Vegas (NV); On-site; USD 40,000 - 52,000; Full time

Job summary

New Horizon Billing Solutions (NHBS) is seeking a Prior Authorization Specialist to manage insurance verifications, IVR requests, and patient eligibility, ensuring timely authorizations and a clean revenue cycle.

The role requires HIPAA-compliant communications, strong attention to detail, and experience with payer portals, Medicare rules, and CPT/ ICD-10 coding; on-site Las Vegas, with regular 9–5 schedule.

Qualifications

• High school diploma or GED required.
• 2+ years of experience in prior authorization, insurance verification, or medical billing/front-office operations.
• Working knowledge of Medicare Part A/Part B eligibility rules, MSP, and commercial payer benefit structures.
• Familiarity with CPT/ICD-10/HCPCS coding and use of payer portals and EHR systems.

Responsibilities

• Review daily verification queues and process IVR requests according to priority indicators and dates of service.
• Verify Medicare eligibility and benefits through MAC portals and commercial payer portals.
• Prepare, submit, and track prior authorization requests with complete clinical documentation.
• Identify missing information and coordinate with client offices to obtain required documentation.
• Send HIPAA-compliant status communications to client contacts and maintain audit-ready documentation.

Skills

Attention to detail

Time management

Professional communication

HIPAA compliance

Education

High school diploma or GED

Tools

Payer portals

EHR systems

Microsoft Office

Job description

New Horizon Billing Solutions (NHBS) is seeking a Prior Authorization Specialist to manage insurance verifications, IVR requests, and patient eligibility, ensuring timely authorizations and a clean revenue cycle.

The role requires HIPAA-compliant communications, strong attention to detail, and experience with payer portals, Medicare rules, and CPT/ ICD-10 coding; on-site Las Vegas, with regular 9–5 schedule.