Prior Authorization Specialist II

OU Health; Oklahoma; Hybrid; USD 44,000 - 60,000; Full time

Job summary

OU Health is seeking a Prior Authorization Specialist II in Oklahoma. The role supports pre-visit services, working with multiple payers and specialties to manage authorizations and ensure medical necessity documentation is obtained.

Remote eligibility is limited to candidates residing and working in OK, with on-site presence required at least monthly. The ideal candidate has at least 3 years of prior authorization experience, High School Diploma or GED, and CHAA or PACS certification within the

Qualifications

• Experience in pre-visit services and authorizations.
• Ability to interpret payer policies and utilization criteria.
• Experience with denial trends and corrective actions.

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

Policy interpretation

Authorization requirements

Analytical skills

Written & verbal communication

Education

High School Diploma or GED

Job description

## Prior Authorization Specialist IIApply: WFH State of Oklahoma: Full time: Posted Today: R0069712## **Position Title:**Prior Authorization Specialist II## **Department:**Pre-visit Services## **Job Description:*****New to OU Health? Ask your recruiter about our competitive wages and total rewards package.*****Remote Eligibility:** Candidates must reside and work full-time in **OK** before their first day of employment.**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.