Remote/Hybrid Prior Authorization Specialist

AC3; South Bend (IN); Hybrid; USD 42,000 - 64,000; Full time

Benefits offered by this job

Medical, dental, and vision benefits

Employer paid life insurance

Short and long-term disability

Company-matched 401(k) plan

Paid time off and wellness program

Job summary

AC3 is seeking a Prior Authorization Specialist to collaborate with clients, insurers and patients to obtain approvals for radiology, radiation therapy, procedures and chemotherapy drugs. You will document required information in our systems and ensure all insurer requirements are met.

Ideal candidates have medical office experience, strong communication and organizational skills, attention to detail, and the ability to work in a fast-paced environment while maintaining confidentiality.

Qualifications

• High school diploma or GED is required.
• Medical office experience or familiarity with medical terminology preferred.
• Detail oriented with problem-solving abilities.
• Proficient in Microsoft Office.
• Experience with electronic medical records (EMR) or EMR software.
• Ability to work with patients and families in a confident, respectful manner.
• Excellent communication and organizational skills in a fast-paced environment.

Responsibilities

• Understand insurance requirements for prior authorization.
• Submit appropriate authorization requests to payers.
• Verify that all insurance requirements are met before noting approvals.
• Document required information in PM and EMR systems.
• Serve as primary contact with outside facilities and clients.
• Respond to client emails and calls within the policy timeframe.
• Follow HIPAA rules and maintain confidentiality.

Skills

Communication skills

Organizational skills

Problem solving

Detail oriented

Interpersonal skills

Education

High school diploma or GED

Medical terminology knowledge

Tools

Microsoft Office

EMR software

Job description

AC3 is seeking a Prior Authorization Specialist to collaborate with clients, insurers and patients to obtain approvals for radiology, radiation therapy, procedures and chemotherapy drugs. You will document required information in our systems and ensure all insurer requirements are met.

Ideal candidates have medical office experience, strong communication and organizational skills, attention to detail, and the ability to work in a fast-paced environment while maintaining confidentiality.