Provider Customer Service Representative / Prior Authorization Specialist / Member Service / Utilization Review Specialist

Diverse Lynx; United States; A distancia; USD 19.000 - 28.000; Jornada completa

Descripción de la vacante

Diverse Lynx, LLC is seeking a detail-oriented Prior Authorization Specialist / Provider CSR to support provider enablement activities in a remote (work from home) setup. The role focuses on pre-authorization processes, back-office operations, and administrative support within healthcare workflows.

The ideal candidate will have experience with medical platforms, ICD-10/CPT coding, and strong documentation skills, enabling efficient remote collaboration with providers and internal teams.

Formación

• High School Diploma or equivalent (documentation required).
• Minimum 1 year of work-from-home experience with high-speed internet.
• At least 1 year of experience with back-office medical platforms and/or authorization systems.
• Minimum 1 year of experience in the healthcare industry (hospital, physician’s office, or clinical setting).
• Working knowledge of medical terminology, ICD-10 and CPT codes, Medicare and/or Medicaid services.
• Professional experience in clerical or administrative support roles.
• Ability to quickly learn and adapt to new systems and applications.
• Proficiency in using computers/laptops and tools such as Outlook, Microsoft Teams (including screen sharing), Word, and Excel.

Responsabilidades

• Handle pre-authorization processes and related back-office operations.
• Perform backend administrative tasks and outbound/inbound calling activities as required.
• Work with medical platforms and authorization systems to process requests.
• Review and verify healthcare documentation and coding (ICD-10, CPT).
• Coordinate with internal teams and providers to ensure timely approvals.
• Maintain accurate records and documentation; perform administrative and clerical support tasks as needed.
• Utilize multiple systems and applications efficiently in a remote setup.

Conocimientos

Healthcare terminology

ICD-10 codes

CPT codes

Administrative support

Remote work experience

Educación

High School Diploma

Herramientas

Outlook

Microsoft Teams

Word

Excel

Descripción del empleo

Job Title: Prior Authorization Specialist / Provider CSR

Location: Remote (Work from Home)

Employment Type: Full-Time

Pay Rate: $17/hour

Work Schedule

• This is a full-time role requiring 40 hours per week
• Candidates must be flexible to work Saturday shifts as part of the weekly schedule
• Operational Hours: Monday to Sunday, 7:00 AM – 7:00 PM CST (shift will be assigned within this window)
• Training Schedule: Monday to Friday, 9:30 AM – 6:00 PM CST

Job Summary

We are seeking a detail-oriented and experienced Pre-Authorization Specialist to support provider enablement activities. The ideal candidate will have a strong background in healthcare operations, authorization processes, and administrative support, along with the ability to work efficiently in a remote environment.

Key Responsibilities

• Handle pre-authorization processes and related back-office operations
• Perform both backend administrative tasks and outbound/inbound calling activities as required
• Work with medical platforms and authorization systems to process requests
• Review and verify healthcare documentation and coding (ICD-10, CPT)
• Coordinate with internal teams and providers to ensure timely approvals
• Maintain accurate records and documentationPerform administrative and clerical support tasks as needed
• Utilize multiple systems and applications efficiently in a remote setup

Basic Requirements

• High School Diploma or equivalent (documentation required)
• Minimum 1 year of work-from-home experience with high-speed internet
• At least 1 year of experience with back-office medical platforms and/or authorization systems
• Minimum 1 year of experience in the healthcare industry (hospital, physician’s office, or clinical setting)
• Working knowledge of medical terminology, ICD-10 and CPT codes, Medicare and/or Medicaid services
• Professional experience in clerical or administrative support roles
• Ability to quickly learn and adapt to new systems and applications
• Proficiency in using computers/laptops and tools such as Outlook, Microsoft Teams (including screen sharing), Word, and Excel