Remote Prior Authorization Specialist

Thornton Tomasetti; Madison (WI); Remote; USD 25,000 - 41,000; Full time

Job summary

Abbott in Madison, WI is hiring a Prior Authorization Associate I to handle initial and ongoing patient eligibility verification and authorization processes within Epic. You will work across departments to ensure timely and accurate approvals and denials handling, with a focus on quality and regulatory compliance.

The role requires 2+ years in prior authorization workflows and 3+ years in medical billing/claims, with strong attention to detail and HIPAA compliance.

Qualifications

• High School Diploma or GED required.
• 2+ years directly involved in submission and follow up of Prior Authorization workflows.
• 3 years of experience in medical billing, claims, and/or insurance processing.
• Extensive knowledge of government, managed care, and commercial insurances claim submission requirements.
• Knowledge of medical terminology and health insurance terms.
• Authorization to work in the United States without sponsorship.

Responsibilities

• Independently verify initial or ongoing patient insurance eligibility and document updates in Epic.
• Interact with insurances to obtain authorization and document per policies.
• Review/edit claims and appeals prior to submission to clearinghouse.
• Investigate payor underpayments and resolve denial issues.
• Provide ad-hoc support within the department and manage queues.

Education

High School Diploma or GED

Associate degree or medical billing certification

Job description

Abbott in Madison, WI is hiring a Prior Authorization Associate I to handle initial and ongoing patient eligibility verification and authorization processes within Epic. You will work across departments to ensure timely and accurate approvals and denials handling, with a focus on quality and regulatory compliance.

The role requires 2+ years in prior authorization workflows and 3+ years in medical billing/claims, with strong attention to detail and HIPAA compliance.