Revenue Cycle Pre-Authorization Specialist (Remote)- Full-Time/Days

This is a Fully Remote Job About Our Client:The organization operates within the healthcare sector, focusing on facilitating hospital services and imaging for patients. It addresses the challenge of managing insurance prior authorizations efficiently to ensure scheduled medical services proceed without delay. By coordinating between providers and insurance carriers, the program supports timely access to surgeries, imaging, cardiology testing, and other procedures. About the Opportunity:The REVENUE CYCLE PRE-AUTHORIZATION SPECIALIST is responsible for obtaining prior authorizations for scheduled medical services across hospital locations, including imaging centers. This role ensures accurate demographic and insurance information is recorded and acts as a liaison between providers and insurance companies to secure necessary approvals. The position is critical in maintaining workflow efficiency and reducing delays in patient care. Responsibilities:Communicate with insurance companies to obtain prior authorizations for various medical servicesVerify insurance eligibility and update electronic medical records accordinglyInitiate prior authorization requests via phone or payer portalsSubmit required medical documentation to support authorization requestsRequest medical records, updated orders, and insurance information from providers as neededMonitor worklists for urgent scheduling add-ons to obtain authorizations promptlyCoordinate peer-to-peer review requests between insurance plans and providersPersistently follow up on authorization status with insurance carriersUpdate patient accounting systems with authorization detailsNotify scheduling, registration, and providers of delays or rescheduling due to payer issuesUnderstand payer policies on authorization requirements and timelinesRespond appropriately to communications including phone calls, emails, and messaging platformsComply with healthcare regulations including HIPAA, The Joint Commission standards, CMS, EMTALA, and organizational policiesProvide courteous service to patients, families, teammates, and department staff by resolving inquiries and strengthening relationshipsCover other shifts and departments within Acute Revenue Cycle as neededAssist in training new hiresPerform additional duties as assigned Requirements:High school diploma or equivalentProficiency with Microsoft Office and typing skillsStrong computer skills with multitasking ability across multiple applicationsHigh level of customer service, attention to detail, critical thinking, and effective communication skillsAbility to work independently while maintaining productivity Preferred Qualifications:Some college experience in healthcare, business, or accounting; professional certification preferredAssociates or bachelor’s degree in a medical field preferredPrior experience in healthcare revenue cycle and prior authorizationsKnowledge of ICD-10, CPT codes, medical terminology, and insurance plansAbility to communicate financial and insurance information clearly Pay Range and Compensation Package:Salary Range: $19.32 - $28.01 per hour Equal Opportunity Statement: Our client is an equal opportunity employer. They celebrate diversity and are committed to creating an inclusive environment for all employees. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, gender identity or expression, sexual orientation, or national origin. Note:TalentHop is a recruitment partner of this role. Please note that all employment decisions, including candidate assessment, interviews, hiring, compensation, and employment terms, are made exclusively by the hiring employer.