Prior Authorization Specialist II

OU Health; Lawton (OK); On-site; USD 42,000 - 62,000; Full time

Benefits offered by this job

PTO

401(k)

Job summary

OU Health is seeking an experienced Prior Authorization Specialist II to manage complex authorization requests across multiple payers and specialties. The role requires strong knowledge of payer policies and utilization management, with close collaboration with clinical teams to obtain medical necessity documentation.

The position is based in Lawton, Oklahoma, with on-site requirements and occasional on-site engagement as needed.

Qualifications

• 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.
• Knowledge, skills & abilities include payer policy interpretation, specialty authorization requirements, denial trends analysis, and strong communication.

Responsibilities

• Independently manage complex and specialty‑specific authorization requests.
• Interpret payer medical policies and utilization management criteria.
• Resolve authorization denials and incomplete determinations.
• Coordinate with clinical teams to obtain medical necessity documentation.

Skills

Payer policy interpretation

Authorization experience

Communication skills

Denial analysis

Education

High School Diploma or GED

Tools

CHAA/PACS certification (after 1 year)

Healthcare payer portals

Job description

Job Description

Position Title

Prior Authorization Specialist II

Department

Pre-visit Services

Remote Eligibility

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

SHIFT

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 II effectively manages complex authorizations across multiple payers and specialties.

Essential Job Duties

Responsibilities listed in this section are core to the position. Inability to perform these responsibilities, with or without an accommodation, may result in disqualification from the position.

• Independently manage complex and specialty‑specific authorization requests.
• Interpret payer medical policies and utilization management criteria.
• Resolve authorization denials and incomplete determinations.
• Coordinate with clinical teams to obtain medical necessity documentation.

General Job Duties

• Performs other duties as assigned

Minimum Requirements

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.

Knowledge, Skills & Abilities

• Applied expertise in payer medical policy interpretation.
• Strong knowledge of specialty‑driven authorization requirements.
• Ability to analyze denial trends and recommend corrective actions.
• Excellent written and verbal communication skills.

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.