Bilingual Prior Authorization Specialist
New
S
Staffing for DoctorsHealthcare
Colombia. Nicaragua. Honduras. Guatemala. Peru. El SalvadorFull-TimeMiddle
Salary not disclosed
Apply NowOpens the employer's application page
Job Details
- Languages
- English/Spanish
- Experience
- 2+ years
Requirements
- Minimum 2+ years of prior authorization and insurance appeals experience in a U.S. medical practice.
- Bilingual fluency in English and Spanish.
- Clear, articulate English verbal communication.
- Operational understanding of CPT and ICD-10 codes.
- Understanding of medical necessity documentation rules.
- Ability to work under a mandatory automated time-tracker.
- Secure, HIPAA-compliant home office setup.
- Experience with ModMed (Modernizing Medicine) / EMA EHR (Preferred).
- Experience with Optum VoIP phone system (Preferred).
- Background in surgical specialties or diagnostic imaging (Preferred).
Responsibilities
- Submit and secure prior authorizations for procedures, specialty medications, and advanced diagnostics.
- Review clinical charts to ensure documentation meets payer requirements.
- Manage authorization tracking and follow up with utilization management teams.
- Research, write, and submit technical appeals for denied authorizations.
- Execute eligibility checks and track deductibles and coverage exclusions.
- Monitor authorization expiration dates and renewal cycles.
- Manage patient and provider communication via Optum VoIP phone system.
- Document authorization outcomes within the EMR system.
View Full Description & ApplyYou'll be redirected to the employer's site
