Prior Authorization & Utilization Specialist

Paycom; Nebraska; On-site; USD 26,000 - 43,000; Full time

Job summary

Cozad Community Health System in Cozad, NE is seeking a detail‑oriented Prior Authorization Specialist to obtain authorizations for outpatient and inpatient services. You will verify patient data, submit requests via insurance portals, and monitor timeliness while upholding HIPAA and patient safety.

You will support utilization review, coordinate with billing and providers, and stay current on payer rules and CPT/HCPCS updates.

Qualifications

• High school diploma or equivalent is required.
• Electronic Health Records experience and medical terminology knowledge.
• Ability to examine documents for accuracy and work with computer systems.

Responsibilities

• Responds to correspondence from providers and patients regarding prior authorization.
• Submits authorization requests via insurance portals or by phone.
• Reviews demographic and insurance information for accuracy; coordinates with providers and billing.
• Researches current payer rules and maintains authorization criteria for UR and approvals.

Skills

EHR experience

Medical terminology

Computer literacy

Education

High school diploma or equivalent

Job description

Cozad Community Health System in Cozad, NE is seeking a detail‑oriented Prior Authorization Specialist to obtain authorizations for outpatient and inpatient services. You will verify patient data, submit requests via insurance portals, and monitor timeliness while upholding HIPAA and patient safety.

You will support utilization review, coordinate with billing and providers, and stay current on payer rules and CPT/HCPCS updates.