Pre Authorization Specialist II

About the Opportunity:

The Pre-Authorization Specialist II performs advanced benefit verification and pre-authorization functions with insurance carriers for new pre-surgical cases within an established time frame. This role supports pre-surgical case submissions to the Pre-Authorization Support Department and follows a remote work model.

Responsibilities:

• Answer incoming calls through the toll-free Pre-Authorization Support ACD and handle calls/cases appropriately

• Perform benefit verification, pre-surgical authorization, and appeals by working with all payers

• Use advanced Microsoft Office and database management skills to document case status, actions, and outcomes

• Communicate and build relationships with healthcare professional offices and sales representatives regarding case inquiries

• Notify appropriate internal departments of relevant information including complaint handling and adverse event notifications

• Apply advanced customer service skills to engage with customers, sales representatives, and team members in a call center environment to expedite case processing

• Maintain current metric standards

• Provide support to internal teams, healthcare professional offices, and sales representatives

• Suggest and evaluate continuous process improvements

• Coordinate with lead and supervisor on complicated cases

Requirements:

• 1 to 2 years of experience with a High School Diploma or equivalent experience, training, or apprenticeships

Compensation:

• Minimum salary $37,544

• Maximum salary $63,856

• Compensation varies based on location, experience, education, licensure, certifications, and organizational needs

• Non-exempt hourly roles may include variable compensation such as overtime, shift differential, and annual bonus target (subject to eligibility)

• Exempt roles may include variable compensation such as annual bonus target and long-term incentives (subject to eligibility)

Note:

RemoteHunter is not the Employer of Record (EOR) for this role. Our purpose in this opportunity is to connect exceptional candidates with leading employers. We help job seekers worldwide discover roles that match their goals and guide them to complete their full application directly through the hiring company’s career page or ATS.