Prior Authorization Specialist - Remote/Nationwide

Davita Inc.; United States; Remote; USD 50,000 - 70,000; Full time

Job summary

A leading healthcare organization seeks a Prior Authorization Specialist to collaborate with insurers and manage pre-authorizations for medications and treatments. The ideal candidate will have experience in healthcare policy and possess excellent communication and problem-solving skills. You'll play a key role in enhancing patient advocacy while ensuring compliance with regulations.

Benefits

Health Insurance

Fully Paid Life Insurance

Paid Holidays

401(k) Program with Employer Match

Tuition Assistance Program

Qualifications

• Strong written and verbal communication skills.
• Ability to work effectively in a fast-paced environment.
• Experience with medical terminology and CPT/HCPCS.

Responsibilities

• Collaborate with insurers to obtain pre-authorizations.
• Submit prior authorization requests for medical procedures and treatments.
• Maintain records of all prior authorization requests and outcomes.

Skills

Communication

Problem-Solving

Attention to Detail

Patient Advocacy

Education

Minimum 2 years of prior authorization experience

Understanding of healthcare insurance systems

Tools

Microsoft Office

Word

Excel

Outlook

Job description

Prior Authorization Specialist - Remote/Nationwide

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

United States

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Prior Authorization Specialist

#2307 | Posted 05/08/2025

United States

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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 in keeping with Signature's legacy both internally and externally.

• Tell us about your experience with Prior Authorizations.
• Are you a team player and a self-motivator?
• What is your experience with conducting business in a way that is credit to a company?
• We are counting on you to manage multiple projects using your problem-solving skills.
• We are looking for someone UNCOMMON. What is uncommon about you?

Are you highly committed? Are you team-oriented? Do you value professionalism, trust, honesty, and integrity? If so, we cannot wait to meet you.

About The Position

• Collaborate with insurers to obtain pre-authorizations for condition-specific medications, diagnostic procedures and treatments, and support patients in navigating barriers / coverage and disputes.
• Submit prior authorization requests for medical procedures, diagnostic tests, treatments, and medications as required by insurance providers.
• Gather, review, and submit all necessary clinical documentation to support authorization requests, ensuring accuracy and completeness.
• Communicate with insurance representatives to clarify requirements, resolve authorization denials, and follow up on pending approvals.
• Collaborate with physicians, nurses, and other clinical staff to obtain additional clinical information or documentation required by insurance companies.
• Inform patients about the status of their authorization requests, answer questions regarding coverage, and provide guidance on next steps.
• Maintain accurate and detailed records of all prior authorization requests, outcomes, and patient information in compliance with HIPAA regulations.
• Stay updated on changes in insurance policies, state and federal regulations, and organizational policies affecting prior authorizations and reimbursement.
• Meet quality and productivity standards set by Signature and/or our client.
• Provide excellent customer service in keeping with Signature's legacy both internally and externally.
• Maintain expertise in multiple current client systems.
• Maintain up to date knowledge of revenue cycle management, industry trends perform other duties as necessary.
• Acts as an effective team member.
• Minimum 2 years of prior authorization experience, insurance coordination, or case management within a physician office, hospital, or insurance plan authorizations unit.
• Understanding of healthcare insurance systems
• Strong written and verbal communication skills with the ability to explain complex medical and insurance information
• Strong attention to detail
• Passion for patient advocacy with a problem-solving mindset, focusing on overcoming challenges to accessing care.
• Ability to work effectively both independently and as part of a multidisciplinary team
• Computer proficiency including Microsoft Office, Word, Excel and Outlook
• Ability to function effectively in a fast-paced environment.
• Personal traits of a high-level commitment, motivation, energy, team orientation, professionalism, trust, personal honesty and integrity, and a demonstration of placing others in a place of high value.

Preferred Requirements:

• Preferred experience and understanding of medical terminology
• General knowledge of CPT/HCPCS and ICD-10

About Us

You are uncommon. We are, too. We are looking for people to help us in our mission of working hard at lowering healthcare administrative costs for federal government agencies, payers, and providers. At Signature, our mission is to improve the health of our clients' business and make the lives of the people we work with better. As we continue to experience exponential growth, we are looking for uncommon individuals to enhance our vision. We will continue to accomplish our mission by leading with our values of Passion, Courage, Integrity, and Respect in all interactions, making us a consistent annual Best Places to Work organization. We need uncommon leaders with uncommon qualities to shape our uncommon culture and achieve our uncommon mission.

About the Benefits

When you are a member of Signature Performance, you are a part of a solutions-based organization where the values of passion, integrity, courage, and respect are the driving forces behind all our decision-making. We trust you to do important work and bring the best version of yourself to work every day, so we want to help you achieve a work-life balance while consistently challenging yourself. Signature believes in fully developing each one of our Associates. Our performance-driven philosophy boasts competitive pay and additional position specific incentives, where world-class training and development, resources, and events drive our award-winning culture where everyone thrives.

• Health Insurance
• Fully Paid Life Insurance
• Fully Paid Short- & Long-Term Disability
• Paid Vacation
• Paid Holidays
• Professional Development and Tuition Assistance Program
• 401(k) Program with Employer Match

Security Requirements

• U.S. Citizenship, naturalized citizenship, or Permanent status is required for this position.
• All work on all position at Signature Performance must be completed in the continental United States, Alaska, or Hawaii.

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