Strategic Prior Authorization Specialist – Payer Expert

Gebbs Healthcare Solutions Inc; United States; Remote; USD 55,000 - 85,000; Full time

Job summary

Gebbs Healthcare Solutions Inc. is hiring for an Authorization Representative to manage prior authorization, eligibility verification, and reimbursement workflows. You will initiate and track requests, verify patient benefits, and coordinate with payers to minimize delays and denials.

The role requires attention to detail, strong communication, and experience with payer portals and CPT codes. Collaboration with billing and clinical teams is essential for timely approvals.

Qualifications

• Experience managing prior authorization and eligibility verification.
• Knowledge of payer timelines, submission processes, and tracking.
• Ability to manage multiple queues with deadlines.
• Familiar with HIPAA and patient privacy requirements.

Responsibilities

• Initiate, submit, and track prior authorization requests across payers.
• Verify eligibility and benefits before submission.
• Monitor pending requests and follow up to resolution.
• Document authorization numbers, CPT codes, and dates in systems.
• Manage concurrent reviews, renewals, and expiring authorizations.
• Coordinate denials/appeals with clinical and operational teams.
• Support audits and reimbursement workflows with complete records.

Skills

Prior authorization experience

Payer portals knowledge

CPT codes knowledge

Revenue cycle understanding

Attention to detail

Strong communication

Tools

Availity Portal

NaviNet Portal

Job description

Gebbs Healthcare Solutions Inc. is hiring for an Authorization Representative to manage prior authorization, eligibility verification, and reimbursement workflows. You will initiate and track requests, verify patient benefits, and coordinate with payers to minimize delays and denials.

The role requires attention to detail, strong communication, and experience with payer portals and CPT codes. Collaboration with billing and clinical teams is essential for timely approvals.