Remote CMA: Prior Authorization Specialist

Medical Associates; Dubuque (IA); Hybrid; USD 45,000 - 65,000; Full time

Benefits offered by this job

Health insurance

401k matching

PTO 24 days/year

FSA / Dependent Care

Life insurance

Job summary

Medical Associates is seeking a full-time CMA to join our team as a Prior Authorization Specialist. The role involves reviewing authorization requests, gathering documentation, and submitting to payers from 8:00am to 5:00pm, Monday through Friday, with potential work-from-home after training.

Location is in Dubuque, IA, with a benefits package including health insurance, 401k matching, generous PTO, FSAs, and life and disability coverage. Strong communication with providers is essential.

Qualifications

• Two or more years of medical office, referral, scheduling, insurance verification, prior authorization, or related healthcare experience preferred.
• Current certification or registration as a Certified Medical Assistant (CMA/CCMA/RMA) is required.

Responsibilities

• Review prior authorization requests and gather needed documentation from the medical record.
• Submit requests to payers, monitor status, follow up, and document outcomes.
• Collaborate with providers and clinical staff to obtain missing information for authorization.
• Communicate authorization status and payer requests to providers and staff.
• Elevate cases requiring medical necessity review or nursing judgment to the appropriate nurse.
• Complete all other assigned projects and duties.

Skills

Medical office experience

Prior authorization

Insurance verification

Healthcare experience

Education

CMA certification

CCMA certification

RMA certification

Job description

Medical Associates is seeking a full-time CMA to join our team as a Prior Authorization Specialist. The role involves reviewing authorization requests, gathering documentation, and submitting to payers from 8:00am to 5:00pm, Monday through Friday, with potential work-from-home after training.

Location is in Dubuque, IA, with a benefits package including health insurance, 401k matching, generous PTO, FSAs, and life and disability coverage. Strong communication with providers is essential.