Remote PRP Prior Authorization Specialist

Enterprise Mangement Solutions Inc; Baltimore (MD); Hybrid; USD 6,900 - 8,300; Full time

Job summary

Enterprise Management Solutions, LLC (EMS) seeks a PRP Prior Authorization Specialist to coordinate intake and authorization for clients referred to the PRP and Behavioral Health programs.

Remote position based in Baltimore, MD, with a schedule of 8 hours per day, 40 hours per week, and responsibilities to submit authorizations timely and maintain compliant records across payer requirements.

Qualifications

• High school diploma or equivalent required.
• 1–2 years in healthcare admin, prior authorization, or medical intake.
• Preferred PRP, behavioral health, or outpatient mental health experience.
• MD Medicaid/MCO experience preferred.
• Experience with EHR and payer portals preferred.
• Certifications in Prior Authorization or Medical Billing & Coding preferred or required.

Responsibilities

• Coordinate intake and prior authorization for PRP referrals.
• Submit and track initial and continuing authorizations per payer rules.
• Ensure medical necessity docs are complete; maintain records for audits.
• Monitor authorization expirations and renewal timing.
• Communicate with providers and clinical staff to obtain missing information.
• Update EHRs and internal trackers with authorization status.
• Ensure 3-business-day lead time before service start date.
• Assist with intake calls and triage referrals as needed.

Skills

MD Medicaid

MCO authorizations

PRP knowledge

Attention to detail

Time management

Communication skills

EHR proficiency

Collaboration

Problem solving

Regulatory compliance

Education

High school diploma or equivalent

Associate's or Bachelor's in Healthcare Admin / Business Admin

Tools

EHR systems

Payer portals

Job description

Enterprise Management Solutions, LLC (EMS) seeks a PRP Prior Authorization Specialist to coordinate intake and authorization for clients referred to the PRP and Behavioral Health programs.

Remote position based in Baltimore, MD, with a schedule of 8 hours per day, 40 hours per week, and responsibilities to submit authorizations timely and maintain compliant records across payer requirements.