Prior Authorization Specialist

JOB REQUIREMENTS: Back Prior Authorization Specialist - Endocrinology#26-102 Green Bay, Wisconsin, United States Apply X Facebook LinkedInEmail Copy Location St. Mary's MOB-188 Description This position isfull-time and will work 40-hours per week. It will be full-time benefiteligible. Prior Authorization Specialist Come work where we specializein you We have nearly 2,000 reasons for you to consider a career withPrevea Health-they're our employees. We're an organization that valueskindness, responsibility, inclusivity, wellness and inspiration. AtPrevea, we provide continuous education, training and support so everymember of the team contributes to our success. Together we are the bestplace to get care and the best place to give care. Job Summary ThePrior-Authorization Specialist at Prevea Health is responsible forobtaining and verifying prior authorizations within the appropriatetimeline for procedures, diagnostic tests, services and medications.This role ensures that all requests comply with insurance companypolicies, guidelines, and healthcare regulations. The specialist willcollaborate with healthcare providers, patients, and insurancerepresentatives to obtain the necessary approvals. What you will doIdentify and obtain what is required for preauthorization of procedures,diagnostic tests, services and medications. Seeing the process throughcompletion to minimize denial of claims. Coordinate with departmentproviders and staff, coding/billing staff, and insurance representativesto ensure understanding of information needed to obtain properauthorization for payment within the appropriate timelines. Review andinterpret insurance coverage and policy guidelines to determineauthorization requirements. Communicate with patient as needed forprocedures, diagnostic tests, services and medications to provide themwith information regarding their coverage. Accurately document andcommunicate final determination in the patient's medical record and toappropriate staff, providers, or patient. Work with internal teams toidentify and address trends or issues in the prior authorizationprocess. Provide feedback and recommendations to improve priorauthorization workflows and efficiency. Education Qualifications HighSchool Diploma and/or GED Required Experience Qualifications 1-3 yearsOne year of experience in a medical or insurance role Required Skillsand Abilities Display proficient telephone and computer skills withclear and professional speaking abilities. Excellent organizationalskills. Excellent communication skills and follow through with internaland external customers. Knowledge of insurance and medical terminology.Basic knowledge of current CPT/ICD coding. Able to provide exceptionalcustomer service by assessing patient needs, meeting quality... Forfull info follow application link. Prevea is an Equal EmploymentOpportunity/Affirmative Action employer APPLICATIONINSTRUCTIONS: Apply Online: ipc.us/t/8C96BCE5D9384041

Created: 2026-02-26