Strategic Prior Authorization Specialist

BHMG Lifespan Physician Group, Inc., d/b/a Brown Health Medical Group; South Kingstown (RI); On-site; USD 40,000 - 54,000; Full time

Job summary

Brown University Health's Brown Dermatology in South Kingstown, RI seeks an Insurance Authorization Specialist to manage prior authorizations, verify coverage and arrange visits, procedures, and referrals. You will collaborate with physicians, coordinate documentation, and ensure timely financial clearance from insurers.

The role requires knowledge of CPT/ICD codes, strong organizational and analytical skills, and excellent customer service for patients and providers.

Qualifications

• High school diploma or equivalent required.
• Knowledge of CPT/ICD and registration information.
• Experience with prior authorizations and healthcare terminology.
• Ability to manage high volume of orders and approvals.
• Strong documentation and training capabilities.

Responsibilities

• Collaborates with physicians to obtain prior authorizations.
• Ensures physician orders are complete and scanned in EMR.
• Coordinates documentation from referring physicians.
• Performs peer-to-peer discussions as needed.
• Manages information for insurance denials and authorizations.
• Communicates with patients and providers to resolve issues.

Skills

Medical terminology

Strong organizational skills

Interpersonal skills

Analytical thinking

Customer service

Computer literacy

Education

High School diploma or equivalent

Post-secondary business program (1-year)

Tools

EMR system

Job description

Brown University Health's Brown Dermatology in South Kingstown, RI seeks an Insurance Authorization Specialist to manage prior authorizations, verify coverage and arrange visits, procedures, and referrals. You will collaborate with physicians, coordinate documentation, and ensure timely financial clearance from insurers.

The role requires knowledge of CPT/ICD codes, strong organizational and analytical skills, and excellent customer service for patients and providers.