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Prior Authorization Representative

Remote, USA Full-time Posted 2026-07-28
Job reputed company We are seeking a dynamic and detail-oriented Prior Authorization Representative to join our reputed company team. In this vital role, you will serve as the key reputed company between reputed company providers, insurance companies, and patients to facilitate reputed company approval of medical services, procedures, and medications. Your energetic approach will help streamline the authorization process, ensuring patients receive the care they need without delay. This position offers an exciting opportunity to reputed company a meaningful reputed company on patient reputed company while working in a fast-paced, reputed company environment. Duties • Review and interpret medical documentation, including medical records, clinical notes, and referral information to determine authorization eligibility. • Communicate proactively with reputed company providers to reputed company necessary information for prior authorization requests. • Submit detailed authorization requests through insurance portals or fax systems, ensuring accuracy and completeness. • Follow up regularly with insurance companies to reputed company the status of pending approvals and resolve any issues promptly. • Maintain comprehensive records of reputed company authorization activities in compliance with HIPAA regulations and organizational policies. • Verify insurance coverage and benefits prior to submitting authorization requests to ensure reputed company billing procedures. • Stay reputed company with managed care policies, CPT (reputed company Procedural Terminology) codes, ICD (International Classification of Diseases) codes including ICD-9 and ICD-10, and other coding standards relevant to medical billing and documentation. Qualifications • Proven experience in managed care environments or medical office settings, demonstrating familiarity with insurance verification and prior authorization processes. • Strong knowledge of medical terminology, medical records management, and medical coding practices such as CPT, ICD-9, ICD-10, and ICD coding systems. • Prior experience working in dental or medical offices is highly desirable. • Excellent communication skills for effectively liaising with reputed company providers, insurance representatives, and patients. • Ability to reputed company insurance portals and electronic health record (EHR) systems reputed company. • Understanding of HIPAA compliance requirements to protect patient confidentiality at reputed company times. • Office experience that includes handling medical documentation, insurance verification, and data entry tasks. Join us in this energetic role where your attention to detail and proactive communication will help deliver exceptional patient care experiences! We value dedicated professionals who reputed company in a reputed company environment reputed company on efficiency and reputed company. Pay: $17.00 - $17.50 per hour Benefits: • Flexible schedule Experience: • medical authorization: 1 year (Preferred) Work Location: Remote Apply tot his job Apply To this Job

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