Prior Authorization Specialist - Remote/Nationwide

Signature Performance; United States; Remote; USD 40,000 - 80,000; Full time

Job summary

An established industry player is seeking a Prior Authorization Specialist to join their dynamic team. In this remote role, you will collaborate with insurers to obtain pre-authorizations for medications and treatments, ensuring patients receive the support they need. Your strong communication skills and attention to detail will be essential as you navigate insurance requirements and maintain accurate records. This innovative firm values integrity and professionalism, providing a supportive environment for those passionate about patient advocacy. If you're ready to make a difference in healthcare, this opportunity is perfect for you.

Benefits

Health Insurance

Fully Paid Life Insurance

Disability Coverage

Paid Vacation and Holidays

Professional Development

Tuition Assistance

401(k) with Employer Match

Qualifications

• 2+ years in prior authorization or insurance coordination.
• Understanding of healthcare insurance systems essential.
• Strong communication and problem-solving skills required.

Responsibilities

• Collaborate with insurers for medication and treatment pre-authorizations.
• Submit requests and gather necessary clinical documentation.
• Maintain accurate records and comply with HIPAA regulations.

Skills

Prior Authorization Experience

Healthcare Insurance Knowledge

Strong Communication Skills

Attention to Detail

Problem-Solving Skills

Team Collaboration

Microsoft Office Proficiency

Patient Advocacy

Job description

Prior Authorization Specialist - Remote/Nationwide

Life insurance, paid holidays, sick time, tuition assistance, 401(k)

Location: United States

Position: Prior Authorization Specialist

Job ID: #2307 | Posted: 05/08/2025

Apply now! Click here to apply.

Position Description

About You

You are a person who loves to collaborate with insurers to obtain pre-authorizations. We need someone who has an understanding of healthcare insurance systems. In the role of Prior Authorization Specialist, you will be responsible for providing excellent customer service both internally and externally.

• Share your experience with prior authorizations.
• Are you a team player and a self-motivator?
• Describe your experience conducting business in a professional manner.
• Manage multiple projects using your problem-solving skills.
• What makes you uncommon?

Are you highly committed, team-oriented, and value professionalism, trust, honesty, and integrity? If so, we look forward to meeting you.

About The Position

• Collaborate with insurers to obtain pre-authorizations for medications, procedures, and treatments, and support patients in navigating coverage and disputes.
• Submit prior authorization requests for medical procedures, tests, treatments, and medications.
• Gather, review, and submit all necessary clinical documentation, ensuring accuracy and completeness.
• Communicate with insurance representatives to clarify requirements, resolve denials, and follow up.
• Work with clinical staff to obtain additional information as needed.
• Inform patients about the status of their requests and guide them on next steps.
• Maintain accurate records of all requests and outcomes, complying with HIPAA.
• Stay updated on insurance policies, regulations, and organizational policies.
• Meet quality and productivity standards.
• Provide excellent customer service.
• Maintain expertise in multiple client systems.
• Keep up-to-date with revenue cycle management and industry trends.
• Perform other duties as necessary.

Minimum Requirements

• At least 2 years of prior authorization, insurance coordination, or case management experience.
• Understanding of healthcare insurance systems.
• Strong communication skills.
• Attention to detail.
• Passion for patient advocacy and problem-solving.
• Ability to work independently and in a team.
• Proficiency in Microsoft Office.
• Ability to work in a fast-paced environment.

Preferred Requirements

• Experience with medical terminology.
• Knowledge of CPT/HCPCS and ICD-10 codes.

About Us

We are committed to reducing healthcare administrative costs for government, payers, and providers. Our mission is to improve our clients' business health and enhance the lives of those we serve. We value passion, courage, integrity, and respect, and strive to be a top workplace. We seek individuals with uncommon qualities to help us achieve our mission.

Benefits

• Health Insurance
• Fully Paid Life Insurance
• Disability Coverage
• Paid Vacation and Holidays
• Professional Development and Tuition Assistance
• 401(k) with Employer Match

Security Requirements

• U.S. Citizenship, naturalized, or Permanent Resident status required.
• Work must be completed within the continental U.S., Alaska, or Hawaii.

Apply directly through the employer's website. We are dedicated to helping candidates find great careers and ensure your information is secure and confidential.