Analysis Skills, Claims Management, Clinical Information, Communication Skills, Demographics, Detail Oriented, Document Management, Electronic Medical Records, Employee Assistance Plan, Epic Systems, HIPAA (Health Insurance Portability and Accountability Act), Health Education, High School Diploma, Insurance, Maintain Compliance, Medical Records, Multitasking, Operations, Organizational Skills, Problem Solving Skills, Reimbursement, Team Player, Time Management, Utilization Management
Prior Authorization Specialist – Remote - Idaho State
Position Summary
We’re looking for a driven, detail‑oriented individual to join our team as a Prior Authorization Specialist. You’ll receive training and ongoing support to set you up for success, along with a performance bonus incentive for high achievers. As part of this role, you’ll complete accurate insurance verifications and prior authorizations to ensure timely reimbursement. You’ll also collaborate with clinicians and insurance payors in a fast‑paced environment to manage claims, documentation, and approvals. If you enjoy problem‑solving, staying organized, and making a meaningful impact—both independently and as part of a team—we’d love to hear from you.
Key Responsibilities
- Proficient in Idaho and Washington Payor portals, along with others
- Proficient in EPIC for demographic information, patient clinical notes, and referrals
- Must be proficient in submission of prior authorization in EPIC
- Communicate with providers and insurance companies regarding authorization status.
- Maintain HIPAA compliance and support daily revenue cycle operations.
Skills & Qualifications
- 5+ years of prior authorization experience -Required
- Proficient EPIC
- Strong communication, problem-solving, and organizational skills.
- Detail-oriented, analytical, and able to multitask in a fast-paced environment.
- Proficient in TEAMS
Education & Experience
- High School Diploma required; additional education in business or healthcare preferred.
- Experience in prior authorization, utilization review, insurance verification, and EMR systems. [preferred]
Work Environment & Physical Requirements
- Remote position
- Prolonged computer use; ability to lift up to 15 lbs.
- Reliable Internet
Job Type, Schedule & Compensation
- Full-time, Monday–Friday, 8-hour day shift.
- Pay: $21–$23 per hour, [With additional pay available for exceptional experience.]
Benefits:
- Dental insurance
- Health Insurance
- Accrued Paid Time Off
- Employee assistance program