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Pre-Authorization Specialist

Company: VirtualVocations
Location: Far Rockaway
Posted on: April 22, 2025

Job Description:

A company is looking for a Pre-Authorization Specialist.
Key Responsibilities

Initiate and manage referral authorizations, including gathering information and submitting requests to health plans
Review and process denied claims due to missing authorizations or referrals, and provide feedback to relevant parties
Conduct utilization management medical reviews, ensuring compliance with insurance guidelines and timely processing of referrals

Required Qualifications

High School Diploma / GED
Must be 18 years of age or older
2+ years of experience in healthcare, with knowledge of health plan operations
Experience in Utilization Management or claims billing
Proficiency with EHR/EMR systems and Microsoft Office applications

Keywords: VirtualVocations, East Brunswick , Pre-Authorization Specialist, Other , Far Rockaway, New Jersey

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