Prior Authorizations Specialist - Urology

Be the Best at Getting Better. Join over 40,000 Hartford HealthCare colleagues who make a difference every day. _What We Offer_ Career growth and movement opportunities within our network On-going education and training Robust Benefits Package Generous PTO to promote work/life balance Special Interest Groups Referral Bonus Program /(top leader number of employee referrals in the industry) / Wellness Programs Employee Discount Programs Supportive culture Awards & Recognition Flexible Scheduling Rewarding Compensation 401K with company match Clinical specialty opportunities Hartford HealthCare Medical Groupis one of the largest medical practices in New England with multiple locations throughout Connecticut and Rhode Island. Our physician led medical group enjoys an excellent reputation with patients and the medical community, offering primary care, urgent care and more than 30 different specialties. _Job Description_ Under the direction of the Manager, a Prior Authorization Specialist performs all clerical duties required to obtain insurance prior authorizations for all in office procedures, medications, and any surgical services in a timely manner. Responsible for creating, maintaining and managing resources, including insurance portal access. Must have consistent documentation in EPIC to support the obtained insurance authorization. Will communicate changes in payer and or federal regulatory guidelines to their manager, providers and other clinical departments, as applicable. u00b7 Monitors and reviews the prior authorization work queue daily to verify accuracy of patientu2019s insurance information and to interpret insurance pre-authorization requirements for scheduled procedure, surgery and or medication. u00b7 Contacts insurance companies to obtain prior authorization via telephone and/or portals and provides necessary clinical documentation to ensure authorization is obtained prior to the scheduled date of procedure. u00b7 Documents in EPIC prior authorization information obtained such as number of treatments authorized, length of time treatment is authorized, authorization numbers, and insurance company contact or call reference number. u00b7 Immediately communicates to provider when a procedure, medication or surgery is denied by the insurance company. Assists in setting up peer to peer reviews u00b7 Collaborates and communicates with pharmacy regarding preferred drugs on the particular insurance plan and notifies providers of alternatives u00b7 Maintains log of missed prior authorizations and assists manager with timely retro authorizations or appeals to recoup revenue. u00b7 Collaborates with various hospital departments around billing, information management, policies, procedures and general operations related to prior authorizations. u00b7 When time allows can help out in the office with managing incoming phone calls, baskets and other front desk coverage, answering phones and transcribing orders and referrals. u00b7 Monitoring referral work queue, registering arriving patients, answering incoming calls as well as other assigned duties as needed. High School Graduate/Diploma preferred u00b7 At least one year experience working with insurances and prior authorizations, preferred u00b7 Experience and knowledge of insurances and prior authorizations u00b7 Ability to effectively and professionally communicate with physicians, clinical and administrative staff, managers, patients and insurance companies u00b7 Must be self-motivated and have the ability to work independently and within a team u00b7 Demonstrates excellent telephone, computer, organization and customer service skills With locations around the state, Hartford HealthCare offers exciting opportunities for career development and growth. Here, you are part of an organization on the cutting edge u2013 helping to bring new technologies, breakthrough treatments and community education to countless men, women and children. We know that a thriving organization starts with thriving employees-- we provide a competitive benefits program designed to ensure work/life balance. Start here and be part of something better Job: Administrative Organization: Hartford HealthCare Medical Group Specialists Title: Prior Authorizations Specialist - Urology Location: Connecticut-Hartford-85 Seymour Street - HHMOB (10117) Requisition ID: 26153556

Created: 2026-02-25