About Us:
Meduit is a national leader in healthcare revenue cycle management, supporting hospitals and physician practices in 48 states. We focus on optimizing payments, allowing clients to focus on patient care, and pride ourselves on our core values: Integrity, Teamwork, Continuous Improvement, Client-Focused, and Results-Oriented. Learn more at www.meduitrcm.com.
About the Role:
The Insurance Specialist - Prior Authorization is responsible for obtaining prior authorizations, verifying insurance benefits, and ensuring compliance with payer requirements before services are delivered. This role works closely with patients, providers, clinical teams, and insurance carriers to secure approvals, resolve authorization issues, and support accurate reimbursement.
Success in this role requires strong knowledge of insurance verification, payer guidelines, eligibility requirements, authorization processes, and healthcare revenue cycle operations.
Title: Insurance Specialist - Prior Authorization
Schedule: 8am to 4:30pm Eastern Time Zone, Monday – Friday
Location: Remote, Work-from-home - United States
Compensation: $18 - $21 per hour base
Key Responsibilities:
- Verify patient insurance eligibility, benefits, and coverage requirements.
- Obtain prior authorizations and referrals from insurance carriers in accordance with payer requirements.
- Communicate with insurance companies, provider offices, and patients to collect information necessary for authorization approval.
- Research and resolve authorization-related issues that could impact patient access to services.
- Review accounts for medical necessity, payer requirements, and benefit limitations.
- Document authorization activity and maintain accurate account records.
- Update patient demographic, insurance, and payer information as needed.
- Monitor authorization status and ensure timely follow-up on pending requests.
- Utilize payer portals, eligibility tools, and healthcare software systems to support authorization activities.
- Maintain established productivity, quality, and accuracy standards.
- Collaborate with operational, billing, and clinical teams to support reimbursement and patient access goals.
Required Qualifications:
- High School Diploma or GED
- 2+ years of prior authorization, insurance verification, medical billing, patient access, or healthcare revenue cycle experience
- Experience with Medicare, Medicaid, and commercial payers
- Experience with Workers' Compensation pre-access or authorization processes
- Knowledge of insurance eligibility, authorization, and benefits verification processes
- Proficiency with Microsoft Office (Outlook, Word, and Excel)
Preferred Qualifications:
- Experience working in a hospital, physician practice, or healthcare revenue cycle environment
- Experience using Epic, Cerner, Meditech, or other healthcare information systems
- Experience utilizing payer portals and authorization systems
- Knowledge of medical terminology and coding
- Previous remote healthcare experience
Work From Home Requirements
This is a work-from-home position. Employees are expected to perform their job duties from a secure and private workspace within their home that protects confidential company and client information.
Because employees may access protected health information (PHI), financial information, and other sensitive data, work must be performed in an environment where information cannot be viewed or overheard by others. This position is designed for work to be performed from a dedicated home workspace and is not intended for public locations, shared workspaces, or environments where confidential information may be observed or overheard.
To be successful in this role, employees must have:
- A secure and private workspace within their home
- A reliable wired high-speed internet connection
- Minimum internet speeds of 30 Mbps download and 10 Mbps upload
- The ability to maintain a professional and distraction-free work environment during scheduled working hours
As part of our hiring process for work-from-home positions:
- Candidates will participate in video interviews
- Video interviews may be recorded and transcribed to support candidate evaluation, interviewer collaboration, and hiring decisions
- Candidates may be asked to complete and provide the results of an internet speed test during the interview process to verify minimum technical requirements
Employment eligibility:
- Candidates must be legally authorized to work in the United States at the time of hire
- The company does not provide employment visa sponsorship for this position
- As a condition of employment, a pre-employment background check will be conducted
- Certain positions may also require pre-employment drug testing
- At this time, we are unable to consider candidates residing in the state of New York for this position
What We Offer:
✓ Comprehensive Paid Training
✓ Medical, Dental & Vision Insurance
✓ HSA & FSA Available
✓ 401(k) with Company Match
✓ Paid Wellness Time & Holidays
✓ Employer-Paid Life Insurance & Long-Term Disability
✓ Internal Growth Opportunities
Meduit is an Equal Opportunity Employer. We do not discriminate based on any protected class and welcome applicants from all backgrounds, consistent with applicable laws. Employment is contingent upon successful completion of a background check, satisfactory references, and any required documentation.
Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions of this position.
#LI-Remote
High school diploma or GED and 2+ years of prior authorization, insurance verification, medical billing, patient access, or healthcare revenue cycle experience. Requires payer knowledge and Microsoft Office proficiency.
Key Responsibilities
- verifying eligibility
- obtaining authorizations
- documenting activity
Skills & Tools
Microsoft Outlook, Microsoft Word, Microsoft Excel, Epic, Cerner, Meditech
Job Details
- Category: Healthcare Services - Allied Health
- Seniority: Entry Level
- Commitment: Full Time
- Workplace: Remote — United States or Rocky River or North America
- Salary: USD 37,440 – 43,680 / year
- Languages: English
Benefits
- 401k matching
- Retirement plan
About Meduit
A healthcare revenue cycle management company supporting hospitals and physician practices. — Industry: Healthcare