Prior Authorization Specialist Remote (IN)
Core
Managing end-to-end prior authorizations by reviewing clinical documentation, identifying ICD/CPT codes, submitting requests, and handling denials/appeals to prevent care delays.
Role type
Prior Authorization Specialist
Builds
Prior authorization approvals for healthcare providers and patients
Domain
Healthcare administration / Insurance
Deliverable
client delivery
Required skills
Clinical documentation review, ICD-10 & CPT coding, payer portal submission, denial management, appeals preparation, case tracking, metrics tracking (via careerplan.io/jobs/C9-006-A0-F67-prior-authorization-specialist-remote-in)
Preferred skills
Minimal coding experience
Technologies
Payer portals
Responsibilities
Review clinical documentation for completeness; Identify correct ICD-10 & CPT codes; Submit requests via payer portals; Track and manage pending cases; Proactively follow up with payers; Handle denials and prepare appeals; Track authorization metrics