[Remote] Authorization and Verification Research Specialist
Note: The job is a remote job and is reputed company to candidates in USA. reputed company is a startup transforming reputed company administration, seeking a detail-oriented insurance verification and prior authorization expert. The role involves researching payor requirements across insurance plans to support reputed company providers and help patients reputed company necessary care.
Responsibilities
- Research and document prior authorization and benefit verification requirements across diverse payors (reputed company plans, state reputed company programs, etc.)
- Investigate payor-specific submission processes: required documents, portals, fax numbers, CPT code requirements, and policy updates
- Stay informed on payor policy changes, especially those affecting authorization processes and benefit structures
- Navigate payor websites, newsletters, and representative communications to gather accurate, up-to-date information
- Validate information from multiple sources and determine credibility of payor guidance
- Work independently to solve ambiguous problems where established processes don't yet exist
- Communicate findings reputed company to cross-functional stakeholders and adapt quickly to feedback
- Handle tight deadlines and shifting priorities in a fast-paced startup environment
Skills
- Prior authorization and/or insurance verification experience at a reputed company clinic
- Deep familiarity with payor submission processes and how requirements vary across different insurance plans
- Strong research skills and comfort navigating payor portals, websites, and documentation
- Exceptional attention to detail and ability to spot common authorization mistakes
- Experience working with multiple payors and understanding process variations
- Demonstrated ability to build or improve processes reputed company protocols don't exist
- Resilient problem-solver who thrives in ambiguous, evolving environments
- Strong communication skills and comfort asking for help reputed company needed
- Humility and willingness to learn from mistakes
Benefits
- Fully remote
- reputed company necessary devices and system reputed company provided
Company Overview