Prior Authorization Specialist — Remote-Eligible Care Navigator

DeCoach Recovery; Cincinnati, Northern (OH, KY); Hybrid; USD 40,000 - 64,000; Full time

Benefits offered by this job

Medical, Dental and Vision Benefits

A Company Matched 401(k) plan

Tuition Reimbursement

STAR Eligible Facilities to Assist in

Job summary

DeCoach Recovery is hiring a Prior Authorization Specialist to join our Sharonville-based team in Cincinnati, OH. In this role you will review clinical documentation, obtain approvals from insurance providers, and communicate with payers to ensure coverage requirements are met.

The position offers competitive benefits and room for professional growth. After completing training, the role may transition to remote work, with ongoing responsibilities including tracking requests, resolving denials,

Qualifications

• High school diploma or equivalent; associate or bachelor’s degree preferred.
• Minimum of 2 years experience in prior authorizations or in a revenue cycle role.
• Excellent communication and negotiation skills.
• Proficiency with technology including Microsoft Office Suite.

Responsibilities

• Verify patient eligibility and coverage limits
• Review medical charts to ensure clinical notes match what insurance requires
• Send requests for prior approval to insurance providers
• Track pending cases and follow up with insurance agents

Skills

Prior authorization experience

Communication skills

Negotiation skills

Education

High school diploma or equivalent

Associate or Bachelor's degree preferred

Tools

Microsoft Office Suite

Job description

DeCoach Recovery is hiring a Prior Authorization Specialist to join our Sharonville-based team in Cincinnati, OH. In this role you will review clinical documentation, obtain approvals from insurance providers, and communicate with payers to ensure coverage requirements are met.

The position offers competitive benefits and room for professional growth. After completing training, the role may transition to remote work, with ongoing responsibilities including tracking requests, resolving denials,