Prior Authorization Specialist II - Multi-Payer Expert

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

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.