Prior Authorization Specialist
Robert Half
Job Summary
Robert Half is hiring a Remote Prior Authorization Specialist to verify insurance eligibility, obtain pre-service authorizations, review benefits, calculate patient financial responsibility, and support financial clearance workflows.
Job Description
The Prior Authorization Specialist supports front-end revenue cycle operations by reviewing scheduled services, confirming insurance coverage, securing required authorizations, and helping ensure patients are financially cleared before care is delivered. This role requires knowledge of payer guidelines, benefits review, medical terminology, and authorization workflows.
The position involves documenting authorization activity in EMR/EHR systems, interpreting commercial, Medicare, and Medicaid requirements, following up on approvals, and working across specialty service lines such as cardiology, imaging, surgery, or other clinical areas.
### Key Responsibilities
* Review scheduled patient services for authorization requirements
* Verify insurance eligibility and benefit information
* Obtain initial approvals and follow-up authorizations
* Interpret payer guidelines and coverage requirements
* Calculate patient financial responsibility estimates
* Document authorization activity in EMR/EHR systems
* Support financial clearance and pre-service account readiness
* Work across assigned specialty areas such as imaging, cardiology, or surgery
* Participate in daily remote team huddles
* Maintain productivity standards in a high-volume environment
* Support newer team members with payer and workflow guidance
* Complete additional revenue cycle assignments as needed
### Requirements
* High School Diploma or equivalent
* 6+ months prior authorization experience
* Front-end healthcare revenue cycle experience
* Insurance verification and benefits review knowledge
* Pharmacy benefits knowledge
* Medication coverage knowledge
* Commercial insurance, Medicare, and Medicaid familiarity
* Ability to interpret medical terminology and procedures
* EMR/EHR experience
* Epic experience required
* Ability to work in a high-volume remote environment
### Preferred Qualifications
* Prior authorization experience in imaging, cardiology, surgery, or specialty care
* Patient access experience
* Financial clearance experience
* Healthcare insurance experience
* Remote revenue cycle experience
### Benefits
* Medical insurance
* Dental insurance
* Vision insurance
* Life insurance
* Disability insurance
* 401(k) eligibility
* Free online training through Robert Half
### Phone Level Breakdown
* Authorization follow-up: Moderate
* Insurance verification: Moderate
* Patient financial estimate communication: Moderate
* Documentation: High
* EMR/EHR work: High
* Internal team meetings: Moderate
### Best Fit For
Candidates with experience in prior authorization, insurance verification, patient access, financial clearance, benefits review, pharmacy benefits, healthcare revenue cycle, Epic, medical billing support, and payer portal research.