Prior Authorization Subject Matter Expert Nurse

Description
Each day you are in the office the lives of patients will be improved.
This is not your typical prior authorization job. As our PA Specialist, you will leverage your verification and authorization expertise to update and maintain our business rules library, (a critical part of our software), with the most up to date coverage information. You will also be checking status and/or submitting authorizations when needed to insurance payers. This is a mission critical role, as we require your knowledge and expertise to ensure our products work as intended. In this role you will:
Research, read, understand, and parse prior authorization rules and regulations for insurance companies
Use an internal tool to populate unformatted insurance and authorization requirements into a common format
Keep documentation updated when changes are made to prior auth requirements by insurance companies
Use internal tools to determine if status checks need to be performed on authorization submissions and make phone calls to check the status of those authorizations
Submit authorizations to the specified payer website or check status on the same payer website when available
Requirements
Experience obtaining prior authorization, and navigating insurance verification. You know exactly where to find this information, and how to interpret the requirements. You've likely been doing this for at least 3 years.
Excellent research and comprehension skills when navigating authorization jargon.
High level of comfort navigating unfamiliar technologies.
Ability to work collaboratively, independently, and reliably.
A self-starting mindset. You aren't waiting to be told what to do. You ask questions, determine what needs to be done, and do it until it's complete and correct.
Ability to thrive in ambiguity. You can navigate pivots and changes, and welcome new responsibilities.

Each day you are in the office the lives of patients will be improved.
This is not your typical prior authorization job. As our PA Specialist, you will leverage your verification and authorization expertise to update and maintain our business rules library, (a critical part of our software), with the most up to date coverage information. You will also be checking status and/or submitting authorizations when needed to insurance payers. This is a mission critical role, as we require your knowledge and expertise to ensure our products work as intended. In this role you will:
Research, read, understand, and parse prior authorization rules and regulations for insurance companies
Use an internal tool to populate unformatted insurance and authorization requirements into a common format
Keep documentation updated when changes are made to prior auth requirements by insurance companies
Use internal tools to determine if status checks need to be performed on authorization submissions and make phone calls to check the status of those authorizations
Submit authorizations to the specified payer website or check status on the same payer website when available
Requirements
Experience obtaining prior authorization, and navigating insurance verification. You know exactly where to find this information, and how to interpret the requirements. You've likely been doing this for at least 3 years.
Excellent research and comprehension skills when navigating authorization jargon.
High level of comfort navigating unfamiliar technologies.
Ability to work collaboratively, independently, and reliably.
A self-starting mindset. You aren't waiting to be told what to do. You ask questions, determine what needs to be done, and do it until it's complete and correct.
Ability to thrive in ambiguity. You can navigate pivots and changes, and welcome new responsibilities.