Job Description
Prior Authorization Specialist A Prior Authorization Specialist is responsible for reviewing medical records to determine if treatments, procedures, or medications require prior authorization. They also verify insurance information, process authorization requests, collaborate with other healthcare professionals, monitor and follow up, manage denials, and communicate with patients. Review Medical R
7:00 AM
Review the surgical and procedure schedule for the next 48–72 hours. Every case that requires authorization needs to be cleared be…
7:30 AM
Pull the PA worklist. Filter by date of service — cases with the earliest service dates get worked first. High-cost procedures (su…
8:30 AM
Submit PA requests to payers. Each payer has its own portal, its own forms, its own documentation requirements. You know them all…
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