Remote RCM Prior Authorization Specialist

GeBBS Healthcare Solutions, Inc.; United States; Remote; USD 25,000 - 33,000; Full time

Job summary

GeBBS Healthcare Solutions, Inc. is seeking a detail-oriented professional to manage prior authorizations, eligibility verification, and payer follow-up across commercial and managed care payers.

You will coordinate with clinical and administrative teams to ensure complete documentation and timely processing of authorizations. The role emphasizes managing concurrent reviews, renewals, and preventing gaps in authorization that could delay services or reimbursement.

Qualifications

• Experience in healthcare Revenue Cycle Management with prior authorization, eligibility and benefit verification.
• Prior RCM experience supporting behavioral health services is preferred.
• Strong understanding of prior authorization requirements and payer timelines.
• Knowledge of CPT codes' relationship to payer authorization requirements.
• Experience with payer portals such as Availity and NaviNet.

Responsibilities

• Initiate, submit, and track prior authorization requests across commercial and managed care payers.
• Verify patient eligibility and benefits prior to authorization submission and confirm coverage details.
• Monitor pending authorizations through payer portals and follow up to resolution.
• Manage concurrent reviews, renewals, and prevent gaps that affect reimbursement.
• Document authorization details and support appeals with clinical and operational teams.

Skills

Attention to detail

Analytical skills

Organizational skills

Communication skills

HIPAA knowledge

Tools

Availity

NaviNet

Job description

GeBBS Healthcare Solutions, Inc. is seeking a detail-oriented professional to manage prior authorizations, eligibility verification, and payer follow-up across commercial and managed care payers.

You will coordinate with clinical and administrative teams to ensure complete documentation and timely processing of authorizations. The role emphasizes managing concurrent reviews, renewals, and preventing gaps in authorization that could delay services or reimbursement.