Prior Authorization Specialist

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Remote Eligibility: Candidates must reside and work full-time in OK before their first day of employment.

SHIFT: M-F, Days. Will need to be on-site as needed, at least monthly.

**Ideal candidate will have experience in pre-visit services for multiple areas, working with authorizations.**

General Description

Under general supervision, the Prior Authorization Specialist I complete prior authorization workflows using defined protocols, system and payer rules.

Essential Job Duties

• Submit prior authorization requests using standard payer workflows.

• Verify basic benefits, coverage, and authorization requirements.

• Track authorization status and update Epic accurately.

• Escalate incomplete or nonstandard cases per protocol.

• Collaborate with departments across the organization.

General Job Duties

• Performs other duties as assigned

Minimum Requirements (Level 1)

Education: High School Diploma or GED required.

Certification/License/Registration: None required.

Experience: No experience required.

Minimum Requirements (Level 2)

Education: High School Diploma or GED required.

Experience: At least 3 years of prior authorization experience required.

Certification/License/Registration: CHAA or PACS required after 1 year.

Minimum Requirements (Level 3)

Education: High School Diploma or GED required.

Experience: At least 5 years of prior authorization experience required.

Certification/License/Registration: CHAA or PACS required.

Knowledge, Skills & Abilities

• Foundational understanding of payer types and referral/authorization concepts.

• Ability to follow standardized workflows and documentation requirements.

• Developingproficiencyin Epic andpayer portals.

• Accuracy, timeliness, and compliance focus.

• Good written and verbal communication skills

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