Role OverviewThe Authorization Specialist coordinates and secures insurance pre-certifications and pre-authorizations for medical procedures, outpatient testing, and prescribed medications. This role serves as a liaison between providers, insurance carriers, patients, and external agencies to ensure timely access to care while maintaining complete and accurate documentation within the electronic medical record (EMR).
What You Will Do
The Authorization Specialist supports continuity of care by facilitating appointments, triaging patient communications, and assisting with peer-to-peer reviews to resolve authorization barriers efficiently.
Why It Might Be a Fit
This role requires excellent communication skills, knowledge of medical terminology, CPT & ICD-9 coding, and understanding of pre-certification, prior authorization, and referral requirements across various payer types.
Requirements
- High School Diploma or GED
- Five (5) years of relevant medical office experience
- Knowledge of medical terminology, CPT & ICD-9 coding
- Excellent communication skills
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