Health Information Specialist - Prior Authorization

About the role

We are seeking a motivated Health Information Specialist for a full-time, in-office position. The specialist will manage and maintain the accuracy, security, and privacy of electronic and paper-based medical records, ensure data quality, and comply with legal and industry standards. This role also supports our prior authorizations department by handling medications, insurance communications, prior authorization documents, and appeals with patients and insurance companies.

Responsibilities

• Submit requests to insurance companies, gather necessary documents, complete forms, and follow up on the status of requests.
• Provide updates on authorizations, review requests for completeness, and ensure all supporting documents are submitted to expedite approvals.
• Receive and monitor prior authorization requests within company-set standards.
• Review the accuracy and completeness of information and ensure all supporting documents are present.
• Assist with medical necessity documentation to expedite approvals and ensure appropriate follow-up.
• Collaborate with other departments to obtain prior authorizations or appeals.
• Document all interactions with insurance companies within the EMR system.
• Proactively work on prior authorizations that are due to expire.
• Complete all required duties, projects, and reports in a timely fashion as directed by leadership.
• Perform other duties as assigned.

Requirements

• Previous experience working in a medical or psychiatric facility is preferred.
• Excellent written and oral communication skills.
• Proficient telephone and computer skills.
• Ability to prioritize multiple tasks in a high-stress, changing-priority environment.
• Professional interaction with all levels of staff.
• Medical records and prior authorization experience is preferred but not required.

Benefits

• Health insurance
• Dental insurance
• Vision insurance
• 401(k) matching
• Paid time off