Prior Authorization Specialist

About the role

At Unifi Healthcare, we are reimagining what healthcare can be—accessible, compassionate, and truly patient-centered. Our mission is to deliver a seamless, personalized experience that empowers individuals and supports them through their healthcare journey, helping people live longer, safer lives in the comfort of their own homes. Through our growing network of services and partners, we are building a model that reduces complexity, supports caregivers, and reimagines how at home healthcare is delivered across the U.S. We are looking for a strong writer with clinical experience. The Authorization Escalation specialist is responsible for the successful completion of prior authorizations for Medical Equipment. This process requires high levels of organization, dedication, and persistence. The position serves as an advocate for patients to obtain approvals for their Durable Medical Equipment through the Department of Labor, working at an elevated level. This person must have the ability to problem-solve independently, able to address and resolve confrontation, and oversee daily functions of the authorization team, act as an authorization area float. This person will work closely with medical benefit examiners at the DOL, case managers, patients, and all internal departments.

Responsibilities

• Writing letters of medical necessity, average 20 per day
• Comfortable talking on the phone
• Comfortable working daily with insurance payers to gain prior authorization approval
• Comfortable working with remote teams in multiple states
• Understands and accurately applies requirements for prior authorization
• Ensures eligibility and benefits are properly verified
• Exhibits excellent customer service skills and serves as an advocate for the patient
• Performs other related duties as assigned or requested to maintain a high level of service
• Demonstrates professional work behavior by following Service Standards and Success factors
• Complies with departmental organizational policies and procedures and adheres to external agency requirements
• Ensures compliance with coding and billing regulations, including HIPAA and other industry guidelines
• Maintains accurate and up-to-date documentation of job-related activities, including authorizations, claims, appeals, and internal and external communication

Required Knowledge and Skills

• Demonstrated work history of success with writing, handling prior authorizations, appeals and denials
• Clear communication and effective collaboration to optimize patient care and clinic operations
• Strong writing skills
• Excellent customer service skills
• Ability to collaborate with others and offer outstanding customer service
• High degree of computer literacy in a PC environment
• Strong organizational, interpersonal and communication skills
• Previous experience successfully completing federal payer authorizations (preferred)
• Strong attention to detail and accuracy in data entry, documentation, and claims processing
• Ability to handle confidential and sensitive information with discretion
• Strong problem‑solving and analytical skills to identify and resolve issues
• Ability to work independently, prioritize tasks, and meet deadlines in a fast‑paced environment
• Knowledge of medical terminology, anatomy, and diagnosis codes and/or procedures
• Ability to work independently in a remote setting while effectively managing team collaboration and project deadlines
• Organized, proactive, and able to identify and address potential