Top 3 Prior authorization specialist Jobs in Puerto Rico

Authorization Coordinator
Premium Health Care —Puerto Rico
- $10 - $15 an hour
- Full-time
- Remote
- HIPAA
- Mid-level
- 2 years
- Paid time off
Quick Apply
1d
Case Review Specialist - PR
OncoHealth —Guaynabo, PR
- Weekends as needed
- Hybrid work
- Spanish
- English
- Mid-level
- Health insurance
Quick Apply
Field Reimbursement Specialist
Cencora —Carolina, PR
- Full-time
- Microsoft Excel
- Microsoft Outlook
- Mid-level
- Paid parental leave
- Health insurance

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Authorization Coordinator
Premium Health Care —Puerto Rico
Communicate authorization status with providers, clinical staff, and patients. Work denied authorizations by obtaining additional clinical documentation and…
$10 - $15 an hour
Quick Apply
1d
Case Review Specialist - PR
OncoHealth —Guaynabo, PR
The Case Review Specialist ensures that case documentation is provided by the provider for accurate and timely determinations and communicates with clinical and…
Quick Apply

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Must have prior experience with insurances and prior authorizations. Collaborate with clinical staff to ensure timely approvals for patient treatments.
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Authorization Coordinator

Premium Health Care -
Puerto Rico

Quick Apply

Job Details

Full-time | Contract
$10 - $15 an hour
1 day ago

Benefits

Paid time off

Qualifications

Medical documentation
Medicare
HIPAA
Healthcare referral management
Pre-authorization review for utilization management
Attention to detail
Time management

Full Job Description

Premium Healthcare is a rapidly expanding multi-specialty medical organization serving patients throughout South Florida. We are seeking experienced Authorization & Referral Coordinators to join our remote team in Puerto Rico.

This position is responsible for obtaining insurance authorizations, processing specialist referrals, and securing medication prior authorizations to ensure patients receive timely, uninterrupted care. The ideal candidate is highly organized, detail-oriented, and experienced working with multiple insurance carriers and electronic medical record systems.

Responsibilities

Process medical insurance prior authorizations for diagnostic testing, procedures, surgeries, specialty visits, and treatments.
Submit and manage medication prior authorizations through insurance portals and electronic platforms.
Coordinate referrals with primary care providers, specialists, imaging centers, hospitals, and ancillary services.
Verify insurance eligibility, benefits, and authorization requirements.
Follow up on pending authorizations and appeals to ensure timely approvals.
Communicate authorization status with providers, clinical staff, and patients.
Maintain accurate documentation within the electronic medical record (EMR).
Monitor authorization turnaround times and meet department productivity goals.
Work denied authorizations by obtaining additional clinical documentation and submitting reconsiderations or appeals.
Ensure compliance with payer guidelines, HIPAA regulations, and company policies.
Collaborate with providers, medical assistants, nurses, and referral specialists to minimize delays in patient care.

Qualifications

Minimum of 2 years of experience in medical insurance authorizations and referrals.
Experience with medication prior authorizations required.
Knowledge of commercial insurance plans, Medicare, Medicare Advantage, Medicaid, and managed care organizations.
Experience using insurance portals and electronic authorization systems.
Experience with CoverMyMeds strongly preferred.
Experience with AdvancedMD or similar EMR systems preferred.
Excellent organizational, multitasking, and time-management skills.
Strong written and verbal communication skills.
Ability to work independently in a fully remote environment.
High-speed internet and a dedicated home workspace required.

Preferred Experience

Multi-specialty medical practice
Diagnostic imaging authorizations (MRI, CT, PET/CT, Ultrasound)
Surgical and procedural authorizations
Specialty referrals
Infusion therapy authorizations
Medication prior authorizations
Appeals and peer-to-peer coordination

Pay: $10.00 - $15.00 per hour

Benefits:

Paid time off

Work Location: Remote

Quick Apply

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prior authorization specialist jobs in puerto rico

Authorization Coordinator

Case Review Specialist - PR

Field Reimbursement Specialist

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