Remote Prior Authorization Pro

Koya Medical, Inc.; United States; Remote; USD 55,000 - 60,000; Full time

Benefits offered by this job

Remote work

Competitive benefits

Base salary plus bonus

Job summary

Koya Medical, Inc. is seeking an Authorizations Specialist to secure timely payer approvals by managing authorizations, precertifications, predeterminations, and referrals.

This remote, full-time role leverages strong insurance expertise to navigate diverse health plans and maximize reimbursement. You will collaborate with the Reimbursement Operations team under the Manager, Prior Authorization, handling payer communications, documentation, and internal workflow improvements while ensuring HIPAA

Qualifications

• Experience with prior authorization and reimbursement processes.
• Strong written and verbal communication skills.
• Ability to work independently in a fast-paced environment.

Responsibilities

• Submit medical records to payers for coverage approval.
• Review clinical documentation for medical necessity.
• Process authorizations, precertifications, predeterminations, and referrals across plans.
• Educate payers on product features to support coverage.
• Maintain HIPAA compliance and meet productivity standards.

Skills

Prior authorization

Reimbursement processes

Insurance workflows

Multitasking

Communication skills

Education

High school diploma

Associate or Bachelor’s degree preferred

Tools

Salesforce

Payer portals

Job description

Koya Medical, Inc. is seeking an Authorizations Specialist to secure timely payer approvals by managing authorizations, precertifications, predeterminations, and referrals.

This remote, full-time role leverages strong insurance expertise to navigate diverse health plans and maximize reimbursement. You will collaborate with the Reimbursement Operations team under the Manager, Prior Authorization, handling payer communications, documentation, and internal workflow improvements while ensuring HIPAA