Prior Authorization Representative

Coordinating prior authorization and referral processes for patients, the full-time Prior Authorization Representative will engage with providers and patients to facilitate care, manage scheduling, and ensure accurate benefit eligibility in a hybrid work environment. Key responsibilities Manage prior authorization and referral processes by confirming patient health plan coverage and communicating necessary information to health plans Coordinate scheduling for patients with internal and external departments, ensuring timely and accurate appointments and authorizations Track and update systems with current information regarding prior authorizations and referrals, maintaining oversight of patient work queues Required qualifications High school diploma or GED required; college-level coursework preferred Minimum of one year of experience in a hospital, clinic, or medical insurance billing office related to medical billing or pre-authorization Basic understanding of medical coding Intermediate experience with electronic medical records systems and MS Office applications Ability to perform basic to intermediate math calculations