Monday-Friday | Flexible within regular business hours
Temp‑to‑Hire
The Opportunity
The Prior Authorization Resolution Specialist is responsible for resolving prior authorization (PAR) denials and delays that slow insurance approvals. This role works directly with Primary Care Providers (PCPs), clinics, insurance payers, internal clinical teams, and families to address missing documentation, denials, and requests for additional information.
This position is ideal for healthcare insurance professionals with strong experience in prior authorizations, denials, and appeals who enjoy problem‑solving and cross‑functional collaboration.
Key Responsibilities
Investigate and resolve prior authorization issues and denials
Communicate directly with clinics and PCPs to address documentation gaps
Coordinate with insurance payers, internal teams, clinicians, and families
Analyze denial trends to improve future funding and approval success
Maintain accurate insurance and PAR requirement documentation
Manage PAR cases with urgency to avoid delays in care
Respond to insurance and funding inquiries accurately and timely
Ensure compliance with HIPAA, FERPA, and internal policies
Collaborate on workflow and process improvements using CRM tools
Demonstrate department values of active listening, learning, and leadership
Requirements
Bachelor's degree preferred
3+ years of healthcare insurance or medical funding experience
Strong background handling prior authorization denials and appeals across multiple payers
Experience working directly with provider offices/PCPs
Excellent written and verbal communication skills
Strong analytical and problem‑solving abilities
Ability to multitask efficiently under pressure
Self‑motivated and comfortable working independently and with teams
Adaptability in a fast‑paced, changing environment
Proficiency with data entry, account management, and learning new systems
Demonstrated ability to identify and implement process improvements
Compensation & Schedule
Salary: $67,000-$75,000
Schedule: Monday-Friday, flex
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.