Top 62 Authorization specialist Jobs in Raleigh Nc

Prior Authorization Specialist
Empowered Arthritis and Rheumatology Center PLLC —Cary, NC
- $23 - $28 an hour
- Full-time
- Microsoft Excel
- Microsoft Outlook
- Mid-level
- Health insurance
- Dental insurance
Quick Apply
11d
Authorization Specialist
Raleigh Medical Group PA —Raleigh, NC
- Full-time
- Customer service
- Medical office experience
- HIPAA
- Health savings account
- Disability insurance
Advanced Imaging Authorization Specialist
Raleigh Orthopaedic Clinic —Raleigh, NC
- Full-time
- Hybrid work
- Mid-level
- 2 years
- Health savings account
- Health insurance
Quick Apply
Admissions Coordinator & Authorization/UR Specialist
Joshua Tree Health —Apex, NC
- Full-time
- Hybrid work
- Medical office experience
- HIPAA
- 3 years
Quick Apply
Authorization & Health Information Specialist
North Carolina Specialty Hospital, LLC —Durham, NC
- Hospital
- Customer service
- Computer literacy
- Disability insurance
- Health insurance
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Health Services Specialist
McKesson —Cary, NC
- $17.99 - $29.98 an hour
- Hybrid work
- Mid-level
- 3 years
- Organizational skills
5d
Patient Access Specialist
McKesson —Cary, NC
- $17.99 - $29.98 an hour
- Hybrid work
- Computer literacy
- Mid-level
- Office
- Prescription drug insurance
Health Service Specialist
McKesson —Cary, NC
- $17.99 - $29.98 an hour
- Hybrid work
- HIPAA
- Mid-level
- Office
4d
Surgery Scheduler - Duke Orthopaedics of Raleigh
Duke Health —Raleigh, NC
- Full-time
- Surgery
- Mid-level
- High school diploma or GED
Remote Processing Specialist
CLEAResult Consulting Inc. —Raleigh, NC
- $16 an hour
- Full-time
- Remote
- US work authorization
- Organizational skills
- Entry level
- Health insurance
- Dental insurance
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Administrative Specialist II
State of North Carolina - Health & Human Services —Wake County, NC
- $41,206 - $72,113 a year
- Full-time
- Mid-level
- Office
- Administrative experience
- Paid parental leave
- Health insurance
Insurance Support Services Specialist I
MED-EL Corporation —Durham, NC
- Full-time
- Hybrid work
- HIPAA
- High school diploma or GED
- Math
Quick Apply
Medical Scribe
Oak Street Health —Raleigh, NC
- $17.00 - $28.46 an hour
- Full-time
- Computer literacy
- HIPAA
- Clinic
- Health insurance
- Dental insurance
Financial Coordinator, Fertility Clinic
Atlantic Reproductive Medicine Specialists —Raleigh, NC
- Full-time
- Medical office experience
- 3 years
- Clinic
- Paid holidays
- Disability insurance
Quick Apply
Specialist, Client Management
McKesson —Cary, NC
- $72,000 - $120,000 a year
- Hybrid work
- Microsoft Excel
- Office
- 3 years
Medical Front Desk Receptionist – Referrals & Authorizations
US Foot & Ankle Specialists —Raleigh, NC
- Microsoft Excel
- Microsoft Outlook
- HIPAA
- Paid holidays
- Disability insurance
Quick Apply
14h
Administrative Specialist I
State of North Carolina - Department of Administration —Wake County, NC
- $39,244 - $46,217 a year
- Online Application
- Microsoft Excel
- Microsoft Outlook
- Mid-level
- Paid holidays
- Health insurance
Child Fatality Prevention Administrator / Administrative Specialist II
State of North Carolina - Health & Human Services —Wake County, NC
- $41,206 - $72,113 a year
- Full-time
- Hybrid work
- Office
- Criminal background check
- Military encouraged
- Paid parental leave
- Health insurance
Client Care Specialist - Full Time
FYZICAL Therapy and Balance Centers —Raleigh, NC
- $15 - $24 an hour
- Full-time
- High school diploma or GED
- Clinic
- Computer skills
- Paid holidays
- Health insurance
Quick Apply
21h
Executive Assistant/Legal Assistant
State of North Carolina - Department of Administration —Wake County, NC
- $45,431 - $60,141 a year
- Online Application
- High school
- Research
- Office
- Paid holidays
- Health insurance

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Prior Authorization Specialist

Empowered Arthritis and Rheumatology Center PLLC
Cary, NC

Quick Apply

Job Details

Full-time
$23 - $28 an hour
11 days ago

Benefits

Health insurance
Dental insurance
Paid time off
Vision insurance
Professional development assistance

Qualifications

Appeals
Teamwork
Microsoft Excel
Medical documentation
Microsoft Outlook
Overseeing health insurance pre-certification
Patient service
High school diploma or GED
Medical billing discrepancy resolution
Case appeal in utilization management
Attention to detail
Clinical documentation
Care coordination
Insurance claims appeal handling
Medical billing insurance follow-up

Full Job Description

Prior Authorization Specialist

Specialty Medications / Biologics - Rheumatology

Reports To: Practice Administrator

Work Schedule: Monday – Friday, 8:00 AM – 5:00 PM (1-hour lunch break)

Location / Type: On-site, full-time

Position Summary

We are a Rheumatology practice with an on-site infusion suite, and we are looking for a Prior Authorization Specialist to keep our patients moving smoothly from prescription to treatment. In this role, you will own the prior authorization, benefit verification, and patient financial-assistance process for specialty and biologic medications, serving as the link between patients, providers, payers, specialty pharmacies, and drug manufacturers.

This is a great fit if you have prior authorization, benefit verification, or specialty pharmacy experience and want to grow into the specialty-drug and infusion space. You do not need a rheumatology background to apply. If you are strong on the prior authorization fundamentals, we will train you on our specialty workflows, payer rules, and the medications we use.

Key Responsibilities

Authorization & Access Management

Prepare and submit prior authorizations for specialty and biologic medications through payer portals and electronic prior authorization (ePA) platforms such as CoverMyMeds, SamaCare, or SureScripts.
Track approvals, work denials and appeals, and submit renewals before they expire.
Partner with providers to gather the clinical documentation each authorization needs (labs, step-therapy history, diagnosis codes).

Financial Coordination & Patient Support

Run benefit investigations to determine coverage under the medical vs. pharmacy benefit.
Enroll eligible patients in manufacturer copay assistance, bridge, and free-drug programs to reduce out-of-pocket cost.
Walk patients through their benefits, enrollment requirements, and the timeline to get their medication.

Billing, Coding & Revenue Cycle Support

Verify coverage and reimbursement parameters for buy-and-bill and specialty pharmacy fulfillment models.
Support billing staff with accurate CPT, ICD-10, and HCPCS coding for biologic administration and infusion services.
Review claim submissions through a clearinghouse tool, identify rejections and denials, and initiate resolution or rebill.
Track payer responses and reimbursement timelines so claims process accurately and on time.

Patient Education & Clinical Workflow

Educate patients on their biologic therapy - how it is administered (infusion or injection), the treatment schedule.
Coordinate with the infusion suite on scheduling, inventory availability, and authorization clearance.
Document all communications and actions in the EMR to keep records accurate and current.

Communication & Practice Coordination

Serve as the primary point of contact for patients, providers, insurers, and specialty pharmacies on biologic-therapy questions.
Act as the liaison between the clinical team, infusion suite, billing department, and pharmaceutical representatives for a coordinated patient experience.

Required Qualifications

We are looking for the prior authorization fundamentals below. If you have these, we will train you on the rheumatology and infusion specific parts of the role.

High school diploma or equivalent.
1–2+ years of experience in prior authorization, benefit verification, specialty pharmacy, or a medical-office revenue cycle role.
Hands-on experience with at least one electronic prior authorization platform or payer portal - for example CoverMyMeds, SamaCare, SureScripts, or a payer-specific portal.
Familiarity with insurance verification and working denials and appeals.
Comfortable documenting in an EMR (e.g., eClinicalWorks, Epic, Athenahealth, or NextGen).
Proficient with Microsoft Office (Word, Excel, Outlook).
Detail-oriented, organized, and dependable on follow-through, with strong written and verbal communication skills.
A compassionate, patient-focused approach to care coordination.

Preferred Qualifications

Any of these are a plus:

Prior experience as a Biologic Coordinator, Patient Access Specialist, Reimbursement Specialist, or in a manufacturer patient-support / hub role.
Rheumatology, dermatology, gastroenterology, or similar specialty experience.
Direct experience with specialty biologics such as Humira, Enbrel, Remicade, Actemra, Cimzia, or Stelara.
Working knowledge of CPT, ICD-10, and HCPCS (J-code) coding for specialty drugs and infusion services.
Experience with buy-and-bill reimbursement and infusion suite operations.
Experience with a clearinghouse tool such as TriZetto for tracking and resolving claim denials.
Licensure or certification such as LPN, CMA, RMA, or CPhT.

Why Join Us

Specialized, in-demand skills: you will deepen your expertise in specialty drugs, infusion, and buy-and-bill reimbursement gaining a strong growth path in healthcare revenue cycle and patient access.
Predictable weekday schedule with no nights or weekends.
A collaborative team that supports patients through some of the most meaningful moments in their treatment.

Pay: $23.00 - $28.00 per hour

Benefits:

Dental insurance
Health insurance
Paid time off
Professional development assistance
Vision insurance

Work Location: In person

Quick Apply

Refine Your Search

authorization specialist jobs in raleigh nc

Prior Authorization Specialist

Authorization Specialist

Advanced Imaging Authorization Specialist

Admissions Coordinator & Authorization/UR Specialist

Authorization & Health Information Specialist

Health Services Specialist

Patient Access Specialist

Health Service Specialist

Surgery Scheduler - Duke Orthopaedics of Raleigh

Remote Processing Specialist

Administrative Specialist II

Insurance Support Services Specialist I

Medical Scribe

Financial Coordinator, Fertility Clinic

Specialist, Client Management

Medical Front Desk Receptionist – Referrals & Authorizations

Administrative Specialist I

Child Fatality Prevention Administrator / Administrative Specialist II

Client Care Specialist - Full Time

Executive Assistant/Legal Assistant

I want to receive the latest job alert for authorization specialist in raleigh nc

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