Senior Prior Authorization Specialist II

oumedicine; Central Park (WA); On-site; USD 55,000 - 75,000; Full time

Benefits offered by this job

PTO

401(k)

Medical insurance

Dental plans

Job summary

OU Health is seeking a Prior Authorization Specialist II to manage complex authorizations across multiple payers and specialties from the Pre-visit Services department. Under general supervision, you will coordinate with clinical teams to obtain medical necessity documentation and ensure timely determinations.

The role requires at least 3 years of prior authorization experience, a High School Diploma or GED, and CHAA or PACS certification after 1 year.

Qualifications

• Applied knowledge of payer medical policies.
• Experience with utilization management criteria.
• Ability to analyze denial trends and take corrective action.

Responsibilities

• Independently manage complex and specialty-specific authorization requests.
• Interpret payer medical policies and utilization management criteria.
• Resolve authorization denials and incomplete determinations.
• Coordinate with clinical teams to obtain medical necessity documentation.
• Performs other duties as assigned

Skills

Payer policies interpretation

Authorization management

Denial analysis

Communication skills

Education

High School Diploma or GED

Job description

OU Health is seeking a Prior Authorization Specialist II to manage complex authorizations across multiple payers and specialties from the Pre-visit Services department. Under general supervision, you will coordinate with clinical teams to obtain medical necessity documentation and ensure timely determinations.

The role requires at least 3 years of prior authorization experience, a High School Diploma or GED, and CHAA or PACS certification after 1 year.