Prior Authorization Specialist — Healthcare Operations

Lifespan; Providence (RI); On-site; USD 26,000 - 43,000; Full time

Job summary

Brown University Health seeks a healthcare administrator to manage department insurance prior authorization processes. You will coordinate visits, procedures, drug orders, and referrals, ensuring day hospital financial clearance from insurers.

Knowledge of CPT/ICD and registration information is required. Work involves solving denials, communicating with physicians, and providing high-quality customer service.

Qualifications

• High School diploma or equivalency.
• Knowledge of medical terminology.
• Strong organizational skills for high volume orders.
• Analytical skills to evaluate workflow and improve processes.
• Proficient computer and data entry skills.

Responsibilities

• Coordinate prior authorizations and insurance denials.
• Ensure orders are complete and scanned in EMR.
• Communicate with physicians and staff to obtain documentation.
• Monitor referrals and authorizations and notify registration as needed.
• Provide quality customer service to patients and families.

Skills

Medical terminology

Strong organizational skills

Analytical skills

Interpersonal skills

Computer literacy

Education

High School diploma or equivalent

Tools

Electronic Medical Record (EMR)

Billing systems

Job description

Brown University Health seeks a healthcare administrator to manage department insurance prior authorization processes. You will coordinate visits, procedures, drug orders, and referrals, ensuring day hospital financial clearance from insurers.

Knowledge of CPT/ICD and registration information is required. Work involves solving denials, communicating with physicians, and providing high-quality customer service.