The Prior Authorization Specialist is responsible for obtaining, tracking, and documenting insurance authorizations for medical services, procedures, medications, and treatments. This position works closely with providers, clinical staff, patients, insurance companies, billing, and revenue cycle teams to ensure timely approvals, minimize delays in patient care, prevent authorization-related denials, and support positive patient and financial outcomes. This role is also responsible for proactively verifying payer-specific requirements, monitoring authorization expirations, and ensuring authorizations accurately reflect ordered treatment regimens, drug dosages, frequencies, diagnosis codes, treatment dates, and approved services.
