Remote Prior Authorization & Utilization Review Specialist

Providence Health & Services; Oregon (WI); Remote; USD 39,137 - 59,884; Full time

Benefits offered by this job

Comprehensive benefits package

401(k) with employer matching

Paid parental leave

Health care benefits

Job summary

A leading healthcare organization is seeking a Prior Authorization Specialist to manage core functions and support care efficiently. This role requires strong critical thinking and experience in healthcare. Primary responsibilities include reviewing medical service requests and providing support over the phone to providers and members. Candidates must have a relevant degree or equivalent experience. This position offers 100% remote work for residents of Washington, Oregon, and California.

Qualifications

• 2 years experience in healthcare or equivalent education.
• Experience researching and resolving complex problems.
• Experience with telephony systems and call center operations.

Responsibilities

• Manage core functions in the Prior Authorization Department.
• Review and assess medical service requests for authorization.
• Provide support via incoming calls from providers and members.

Skills

Critical thinking

Database management

Multiline communication

Problem-solving

Education

Bachelor’s Degree in Health related field

Job description

A leading healthcare organization is seeking a Prior Authorization Specialist to manage core functions and support care efficiently. This role requires strong critical thinking and experience in healthcare. Primary responsibilities include reviewing medical service requests and providing support over the phone to providers and members. Candidates must have a relevant degree or equivalent experience. This position offers 100% remote work for residents of Washington, Oregon, and California.