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TYPE OF WORK
Full Time
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SALARY
$5 to $6
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HOURS PER WEEK
40
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DATE UPDATED
Oct 16, 2026
Prior Authorization Specialist — Remote | Direct Hire
We are hiring directly for our company and seeking a detail-oriented Prior Authorization Specialist to support multiple U.S. medical practice locations.
Starting Offer: $5/hour
Schedule: 8:00 AM–4:30 PM California Time (Pacific Time)
Agencies are discouraged
Responsibilities
- Verify insurance eligibility, benefits, copays, deductibles, and coverage effective dates.
- Confirm referral and authorization requirements for HMO, PPO, Medicare, Medicaid, IPAs, and medical groups.
- Review upcoming schedules to identify required authorizations and missing documentation.
- Prepare, submit, and follow up on authorization requests for visits, procedures, and treatments.
- Coordinate with providers to obtain clinical records and supporting documentation.
- Contact insurance companies, IPAs, medical groups, and referring providers to resolve authorization issues.
- Track pending requests through approval or denial and escalate delays before appointments.
- Document authorization numbers, approved services, units or visits, and validity dates.
- Communicate approvals, denials, missing information, and scheduling concerns to the appropriate team.
- Maintain accurate patient records and authorization trackers for assigned locations.
- Assist with authorization-related denials, appeals, and claims follow-up as needed.
- Protect patient information and comply with HIPAA requirements.
Qualifications:
- 2–3 years of experience with U.S. medical insurance eligibility and prior authorizations.
- Familiarity with HMO, PPO, Medicare, Medicaid, IPAs, medical groups, and referral requirements.
- Experience using insurance portals and electronic health record systems.
- Understanding of medical terminology and CPT and ICD-10 codes relevant to authorization requests.
- Experience with authorization denials and appeals preferred.
- Ability to prioritize tasks and meet deadlines across multiple practice locations.
- Strong attention to detail, communication, organization, and follow-through.
- Reliable computer, stable internet connection, and a quiet, private workspace.
