Prior Authorization Specialist

We are seeking a detail-oriented and experienced Prior Authorization Specialist to manage the full lifecycle of prior authorizations (PAs) for medical services. The ideal candidate will be responsible for timely submission, meticulous follow-up, and effective resolution of all prior authorization requests and subsequent appeals. This role is critical in ensuring patients receive necessary services without delay and in maximizing reimbursement for the practice. Key Responsibilities The Prior Authorization Specialist will be responsible for the following core duties: Prior Authorization Submission and Monitoring: Monitor the Prior Authorization queue and manage an organized list of outstanding and in-progress PAs Review patient and service data provided by the biller/clinical team for completeness and accuracy Submit new prior authorizations to the correct insurance company and plan efficiently via the required method, including insurance portals, fax, or telephone Status Follow-Up: Proactively and consistently call insurance companies to check on the status of submitted prior authorizations to prevent processing delays Document all communication and status updates clearly and promptly in the patient management system Denial Management and Appeals: Identify, prepare, and submit prior authorization denial appeals in a timely manner, gathering all necessary clinical and administrative documentation Track the status of all submitted appeals through resolution System and Documentat