Authorization / Precertification Specialist
Company Summary
Our client is seeking an experienced Authorization / Precertification Specialist to join their growing orthopedic practice. This role is ideal for a detail-oriented professional with prior authorization experience who enjoys working in a fast-paced healthcare environment. The successful candidate will be a self-starter with strong communication skills, exceptional attention to detail, and a commitment to providing excellent patient and provider support.
Responsibilities
- Obtain prior authorizations and precertifications for surgical procedures, MRIs, injections, and other services.
- Communicate with insurance carriers to provide documentation and information needed for authorization approval.
- Utilize online insurance portals to submit and track authorization requests.
- Gather and verify patient demographic and insurance information.
- Coordinate with physicians regarding peer-to-peer reviews and authorization requirements.
- Communicate professionally with patients, providers, and staff regarding authorization status and next steps.
- Respond to inquiries from outside organizations regarding patient care and authorization needs.
- Verify patient eligibility and relay updates or changes to appropriate staff.
- Maintain clear, accurate, and concise documentation within the system.
- Manage multiple priorities while maintaining an organized workflow.
- Stay current on assigned work queues and authorization cases.
- Perform other duties as assigned.
Qualifications
- Previous EPIC Experience is required.
- Minimum of 2 years of medical prior authorization/precertification experience.
- Experience obtaining authorizations for surgeries, MRIs, injections, or related services.
- Orthopedic authorization experience preferred.
- Strong attention to detail and organizational skills.
- Ability to work independently and manage multiple priorities.
- Excellent verbal and written communication skills.
- Professional, patient-focused approach to customer service.
- High School Diploma or GED required.
Schedule
- Full-Time
- Hybrid work model
- Location: Farmington, CT
- Can start your day as early as 7:30 AM and finish as late as 6:00 PM (within a 40 hour window)
Pay Rate
$23 - $25.50 per hour (based on experience)
Benefits
- Hybrid Work Opportunity!
- PTO 13 Days on an accrual basis.
- Very nice office and kitchen space, recently moved to a new building.
- 401K 3% match.
- Full benefits.
- Excellent Workplace Environment.
All qualified applicants will receive consideration for employment without regard to race, color, national origin, age, ancestry, religion, sex, sexual orientation, gender identity, gender expression, marital status, disability, medical condition, genetic information, pregnancy, or military or veteran status. We consider all qualified applicants, including those with criminal histories, in a manner consistent with state and local laws, including the California Fair Chance Act, City of Los Angeles' Fair Chance Initiative for Hiring Ordinance, and Los Angeles County Fair Chance Ordinance.