Analysis Skills, Communication Skills, County Ordinances, Customer Relationship Management (CRM) Systems, Data Entry, Documentation, Family Educational Rights and Privacy Act (FERPA), Funding, HIPAA (Health Insurance Portability and Accountability Act), Health Insurance, Insurance, Leadership, Maintain Compliance, Multitasking, Presentation/Verbal Skills, Primary Care, Problem Solving Skills, Process Improvement, Request for Information (RFI), Sales Management, State Laws and Regulations, Time Management, Trend Analysis, Writing Skills
Prior Authorization Resolution Specialist - Remote (MN Residents Only)
- Fully Remote
- $67,000-$75,000
- 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.
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Ultimate Staffing Services