Prior Authorization Specialist Job at Robert Half (Chandler)

Prior Authorization Specialist

We are looking for a skilled Prior Authorization Specialist to support healthcar...

Location

United States , Brea

Salary:

Not provided

Robert Half

Expiration Date

Until further notice

Requirements

Minimum of 1 year of experience in insurance authorization or a related healthcare role
Familiarity with payer guidelines and prior authorization processes
Strong organizational skills with the ability to manage multiple tasks and deadlines
Effective communication skills to interact with insurance providers, healthcare teams, and patients
Proficiency in electronic health record systems and documentation
Ability to interpret clinical documentation and insurance requirements accurately
Knowledge of healthcare terminology and insurance policies
Commitment to maintaining patient confidentiality and compliance with regulations

Job Responsibility

Review clinical documentation, physician orders, and patient charts to identify insurance authorization requirements
Submit and track prior authorization requests for treatments, medications, procedures, and diagnostic tests
Verify insurance eligibility, benefits, and coverage details to ensure patients receive appropriate care
Act as a liaison between insurance providers, healthcare teams, and patients to communicate authorization statuses
Follow up on pending authorizations, addressing inquiries or resolving denials as needed
Maintain detailed records of approvals, denials, and supporting documentation in electronic health systems
Collaborate with clinical and scheduling teams to confirm services are authorized before they are provided
Monitor updates to payer policies and guidelines to ensure compliance with insurance requirements
Initiate appeals for denied authorization requests when justified
Uphold confidentiality standards and organizational compliance in all aspects of patient care

What we offer

Medical, Dental and Vision Insurance
401K Retirement
Sick Time Off
Tuition Reimbursement

Prior Authorization Specialist

PHIL is looking for a full-time Prior Authorization Specialist - with a focus on...

Location

United States

Salary:

21.00 - 25.00 USD / Hour

PHIL

Expiration Date

Until further notice

Requirements

Proven team player, but can solve problems independently as well
Exceptional written and verbal communication skills
Easily adapt to new system and workflow changes
Demonstrate experience working in prior authorizations, medical insurance billing, and/or health insurance (required)
Working knowledge of ICD-10 codes and prescription drug names (preferred, but not required)
Ability to successfully navigate between multiple systems throughout the course of the workday, this includes but is not limited to operational software and vendor portals
Demonstrate flexibility to perform duties wherever volume deems it necessary
Customer service experience (preferred)
Access to reliable, high-speed internet to meet the needs of remote processing (required)

Job Responsibility

Verifies patient insurance coverage utilizing phone or online resources
Submit prior authorizations to insurance plans in a timely manner via electronic portal
Troubleshoots prior authorization submissions and prescription processing with health care providers utilizing phone or online resources
Verbally assist providers in navigating appeals processing
Ensures all pertinent medical documentation is accurate and present prior to authorization submission
Compiles trends in authorization determinations for client and prescriber education
Document activities appropriately in process notes using our operating system
Work closely with our Customer Support team to ensure the success of patients that are recommended to us by their physician's office

What we offer

Ground floor opportunity with one of the fastest-growing startups in health-tech
Solve a problem that matters: be part of a company that uniquely leverages technology to bring wellness to all of its stakeholders

Parttime

Insurance Authorization Specialist

We are seeking a detail-oriented Insurance Authorization Specialist to support t...

Location

United States , Indianapolis

Salary:

Not provided

Robert Half

Expiration Date

Until further notice

Requirements

High school diploma or equivalent required
associate degree preferred
1+ years of experience in insurance authorization, medical billing, healthcare administration, or a related role preferred
Knowledge of commercial insurance, Medicare, Medicaid, and managed care plans
Familiarity with prior authorization and eligibility verification processes
Experience with electronic health records and insurance portals
Strong attention to detail and organizational skills
Excellent verbal and written communication skills
Ability to manage deadlines and work independently in a high-volume environment

Job Responsibility

Verify insurance eligibility, benefits, and coverage details
Obtain prior authorizations and pre-certifications for services, procedures, and medications
Communicate with insurance carriers, providers, patients, and internal teams regarding authorization requirements and status updates
Review documentation for completeness and accuracy before submission
Track authorization requests, approvals, denials, and expirations
Follow up on pending and denied authorizations and escalate issues as needed
Maintain accurate records in billing, practice management, or electronic health record systems
Ensure compliance with payer guidelines, healthcare regulations, and company policies
Assist with appeals and supporting documentation for denied requests
Collaborate with clinical, billing, and administrative teams to reduce delays in service and reimbursement

What we offer

medical
vision
dental
life and disability insurance
401(k) plan

Fulltime

Insurance Authorization Specialist

We are seeking a detail-oriented Insurance Authorization Specialist to support t...

Location

United States , Indianapolis

Salary:

Not provided

Robert Half

Expiration Date

Until further notice

Requirements

High school diploma or equivalent required
associate degree preferred
1+ years of experience in insurance authorization, medical billing, healthcare administration, or a related role preferred
Knowledge of commercial insurance, Medicare, Medicaid, and managed care plans
Familiarity with prior authorization and eligibility verification processes
Experience with electronic health records and insurance portals
Strong attention to detail and organizational skills
Excellent verbal and written communication skills
Ability to manage deadlines and work independently in a high-volume environment

Job Responsibility

Verify insurance eligibility, benefits, and coverage details
Obtain prior authorizations and pre-certifications for services, procedures, and medications
Communicate with insurance carriers, providers, patients, and internal teams regarding authorization requirements and status updates
Review documentation for completeness and accuracy before submission
Track authorization requests, approvals, denials, and expirations
Follow up on pending and denied authorizations and escalate issues as needed
Maintain accurate records in billing, practice management, or electronic health record systems
Ensure compliance with payer guidelines, healthcare regulations, and company policies
Assist with appeals and supporting documentation for denied requests
Collaborate with clinical, billing, and administrative teams to reduce delays in service and reimbursement

What we offer

Medical
Vision
Dental
Life and disability insurance
401(k) plan
Free online training

Fulltime

Referral and prior authorization representative iii

As a community, the University of Rochester is defined by a deep commitment to M...

Location

United States of America , Rochester

Salary:

19.62 - 26.49 USD / Hour

University of Rochester

Expiration Date

Until further notice

Requirements

High School Diploma required
Minimum of two years of relevant experience required, or an equivalent combination of education and experience
Medical Terminology, experiences with appointment scheduling software and electronic medical records preferred
Demonstrated customer relations skills required

Job Responsibility

Serves as the patient referral and prior authorization specialist, with oversight of data and compliance to enterprise standards and referral and prior authorization guidelines
Communicates regularly with patients, families, clinical and non-clinical staff, identifying barriers to appointment compliance, insurance company barriers, and tracking all assistance provided
Accountable for planning, execution, appeals, and efficient follow-through on all aspects of the process, which has a direct, multifaceted impact (quality, financial, patient satisfaction, etc.) on patient scheduling, treatment, care, and follow-up
Adheres to approved protocols for working referrals and prior authorizations
Makes decisions that are guided by protocols and practices requiring some interpretation
maintains an expert-level understanding of the department/division
May train new staff members

Fulltime

Authorization And Referral Support Specialist

We are seeking a compassionate, detail-oriented Authorization & Referral Support...

Location

United States , Las Vegas

Salary:

Not provided

Robert Half

Expiration Date

Until further notice

Requirements

Prior experience in referrals, authorizations, or medical administrative support preferred
Familiarity with medical terminology or healthcare processes
Strong phone etiquette and communication skills
Compassionate, patient-focused approach
Highly organized with the ability to multitask efficiently
Open to early-career candidates (if hold familiarity with medical terminology)
Bilingual preferred but not required

Job Responsibility

Follow up on patient referrals to confirm appointments are scheduled and completed
Contact families and providers regarding referral status and next steps
Manage inbound voicemails and respond to referral-related emails
Assist with clerical and administrative tasks for the authorization/referral team
Utilize internal systems to track referral activity and maintain accurate records
Support coordination of care by ensuring timely communication between patients, families, and providers
Monitor and manage incoming communications to the department

What we offer

Medical, vision, dental, and life and disability insurance
401(k) plan
Free online training
Access to top jobs
Competitive compensation

New

Sr IT Security/Vulnerability Management Specialist

AAC is seeking Senior Security Analyst focusing on Vulnerability Management to j...

Location

United States , Bethesda

Salary:

Not provided

AAC

Expiration Date

Until further notice

Requirements

Requires bachelor’s degree in computer science, cyber security, engineering, or a related technical field. Additional experience and relevant certifications may be considered in leu of a degree.
5-7 years of progressive and related experience in IT security with at least 3 years in vulnerability management.
Expert knowledge of IT security vulnerabilities and risk assessments with the ability to explain the risks associated with them to executives, program, and technology staff.
Expert knowledge of Tenable.sc (on-prem) and Tenable.io (cloud).
Strong knowledge of vulnerability management lifecycle, patch management, and risk scoring (e.g., CVSS2).
Familiarity with cloud platforms (AWS and GCP) and hybrid environments.
Understanding of Windows, Linux/Unix, and network devices security hardening.
Ability to work with program staff, executives, security application vendors and technology staff to achieve IT security goals and objectives.
Experience developing and maintaining Security Assessment and Authorization (SA&A) documentation for large IT systems for the Federal Government.
Excellent working experience in applying FISMA, and FedRAMP processes and policies to information systems.

Job Responsibility

Lead the agency’s vulnerability management lifecycle using Tenable.sc, Tenable.io, Nessus Manager, and Nessus scanners (on-prem and cloud).
Analyze, prioritize, and track remediation of vulnerabilities in coordination with IT operations and system owners.
Maintain scan schedules, asset groups, scan policies dashboards, and reports tailored to agency infrastructure and communicate risk posture and remediation progress to relevant infrastructure, application, and cloud teams to remediate vulnerabilities.
Define the scanner and security center architecture, refine data flows and synchronizations, tune scanning configurations to minimize false positives and ensure the best coverage.
Develop and maintain documentation for system setup, operation, vulnerability management processes, exceptions, and remediation tracking.
Support implementation of security projects that require compliance with relevant government policies or standards.
Act as SME for vulnerability management tools and processes.
Ensure systems and practices comply with FISMA and FedRAMP related Security Assessment and Authorization (SA&A) and compliance for the organization’s IT programs.
Assist in coordination, implementation, communication, and enforcement of the organization’s IT security policies.
Support incident response.

Fulltime

Accounts Receivable Specialist

The Accounts Receivable Specialist is responsible for high volume of processing ...

Location

United States , Chicago

Salary:

21.19 - 24.00 USD / Hour

Ritchie Bros

Expiration Date

Until further notice

Requirements

2-3 years of prior accounts receivable experience
Customer Service experience preferred
Flexibility and willingness to work varied hours and occasional overtime hours
Experience working with ERP systems
Proficiency with Microsoft Excel, Word and PowerPoint
Excellent verbal and written communication skills in English
Excellent interpersonal skills and ability to build relationships
Outstanding analytical and problem-solving skills
Organized, detailed-oriented and able to multi-task in a fast-paced environment
Excellent time management skills and the ability to always meet deadlines

Job Responsibility

Responsible for confirming bid deposits and payments
Uploads auction transactions and enter all accounting adjustments including deductions, price adjustments, collapses, sales tax, pilferage
Processes refunds for overpayments, bid deposits, collapses, price adjustments, and tax adjustments
Ensures appropriate authorizations and policies are adhered to with respect to adjustments
Generates invoices to bill customers, consignors and inter-company subsidiaries
Assists sale site in collections and reconciling customer accounts
investigate and resolve any delinquencies
Notifies departments regarding pertinent receivable balances, adjustments and holdbacks in accordance with timelines
Scrutinize aging of accounts receivable and provide input to management for determining allowance for doubtful accounts (AFDA) per policy
Responsible for Reconciling AR sub-ledger to general ledger

What we offer

medical, dental, vision, and basic life insurances
15 days of PTO each year
401k plan with 100% match for the first 4% contributed

Fulltime

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Prior Authorization Specialist

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