Pre Authorization Specialist II

🔥 0 minutes ago

🌲 North Carolina – Remote

🌲 North Carolina – Remote

💵 $18 - $25 / hour

⏰ Full Time

🟡 Mid-level

🟠 Senior

👻 Ghost score 0%

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Labcorp

WebsiteLinkedInAll Job Openings

10,000+ employees

🏥 Healthcare

💊 Pharmaceuticals

🧬 Biotechnology

💰 $2G Post-IPO Debt - LabCorp on 2024-09

Healthcare • Pharmaceuticals • Biotechnology

Labcorp is a global leader in laboratory services, diagnostics, and drug development. The company provides testing, data and scientific insights to doctors, hospitals, pharmaceutical companies, researchers and patients, reaching more than 160 million patients annually. Labcorp operates a large global laboratory footprint with roughly 71,000 employees across 100+ countries and invests in advanced technologies (including AI and digital solutions) to accelerate drug development, support precision medicines (such as cell and gene therapies and oncology diagnostics), and inform clinical decision-making.

📋 Description

• Conduct benefit investigations and review payer medical policies • Initiate and manage prior authorizations • Provide patient cost estimates • Respond to high-volume billing tasks and inquiries through phone, chats, emails, and portal inquiries • Examine incoming orders for completeness and accuracy of prior authorization documentation • Work with vendors to ensure successful prior authorization submissions • Monitor prior authorization request status and follow up on pending cases • Stay informed about insurance policies and guidelines • Maintain accurate records of authorization requests, approvals, and denials in databases • Collaborate with team members to develop best practices and improve service • Identify issues and suggest potential improvements • Maintain assigned schedules and adapt to changing business needs • Participate in projects beyond day-to-day responsibilities • Provide professional support to providers, patients, and insurance representatives regarding prior authorization status and requirements • Partner with patients, health plans, clients, and internal stakeholders to meet authorization and coverage requirements and support timely billing and reimbursement

🎯 Requirements

• High school diploma with 3 or more years of relevant experience • Associate degree or higher in Healthcare Administration, Business Administration, Health Information Management, or a healthcare-related field (preferred) • 2 or more years of experience documenting healthcare authorization activities within authorization, billing, reimbursement, or revenue cycle management systems (preferred) • 2 or more years of experience working with Labcorp systems, including LCLS and/or LCBS (preferred) • 2 or more years of experience in Revenue Cycle Management (RCM) operations (preferred) • 1 or more years of experience using Microsoft Word, Excel, and Outlook in a healthcare, reimbursement, billing, or authorization environment (preferred) • Ability to work remotely from a private, quiet workspace • Reliable high-speed internet connection (minimum 50 Mbps) • Proficiency with Microsoft Office (Word, Excel, Outlook) • Strong customer service, time management, and organizational skills • Excellent verbal and written communication abilities • High attention to detail with the ability to manage multiple priorities • Solid understanding of medical terminology, insurance guidelines, and healthcare regulations • Self-motivated, collaborative, and willing to take initiative • Strong work ethic, flexibility, and commitment to supporting positive patient outcomes • Problem-solving ability in a fast-paced, team-oriented, and evolving environment

🏖️ Benefits

• Medical insurance • Dental insurance • Vision insurance • Life insurance • Short-term disability (STD) • Long-term disability (LTD) • 401(k) • Paid Time Off (PTO) or Flexible Time Off (FTO) • Tuition Reimbursement • Employee Stock Purchase Plan