Prior Authorization Specialist

🔥 0 minutes ago

🌲 North Carolina – Remote

🌲 North Carolina – Remote

💵 $17 - $19 / hour

⏰ Full Time

🟢 Junior

🟡 Mid-level

🚫👨‍🎓 No degree required

👻 Ghost score 0%

What it means: how likely this posting is sitting open without active hiring.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.How we score it: age, reposts, open roles vs team size, how fast jobs close, and whether pay is listed.Fine print: an estimate from public data, not a judgment of the company. Real jobs can score high, so treat it as a hint, not a fact.

Apply Now

Find Similar Remote Jobs

Set Up Email Alert For New Jobs

📊 Check your resume score for this job

Improve your chances of getting an interview by checking your resume score before you apply.

Upload Resume

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

• Review incoming orders for completeness and accuracy of prior authorization documentation • Initiate and manage prior authorization requests according to payer requirements and medical policies • Work with vendors, payers, and insurance representatives to facilitate prior authorization submissions • Monitor request status, track pending cases, and perform follow-up activities • Review insurance policies, medical policies, and payer guidelines • Perform benefit investigations for reimbursement and pre-billing activities • Respond to billing inquiries through phone, email, chat, portal, and other channels • Provide authorization status updates and requirements information to providers, patients, and insurance representatives • Support resolution of authorization-related and billing-related issues • Maintain records of requests, approvals, denials, and related activities in databases and systems • Enter and maintain authorization, coverage, and benefits information • Identify process improvement opportunities in authorization and reimbursement workflows • Participate in operational improvement projects and initiatives • Maintain productivity and service-level expectations while managing changing priorities • Provide patient cost estimates • Partner with Sales, Operations, Billing, Laboratory teams, payers, providers, and patients to meet authorization and reimbursement requirements

🎯 Requirements

• High School or equivalent • Minimum 2 years’ relevant experience • Successful completion of Labcorp training sessions including Medical Terminology, Anatomy and Physiology, with passing assessment • Ability to work remotely from a private, quiet workspace • Reliable high-speed internet connection of at least 50 Mbps • Customer service practices when supporting providers, patients, insurance representatives, and internal stakeholders • Effective verbal and written communication across multiple platforms • Time management and organizational skills • Attention to detail when reviewing medical policies, insurance guidelines, documentation, and authorization requirements • Knowledge of medical terminology, insurance guidelines, and healthcare regulations • Problem-solving ability in a fast-paced operational environment • Successful completion of a standardized color blindness test • Preferred: Associate degree in Healthcare Administration, Business Administration, Health Information Management, or a healthcare-related field • Preferred: 1+ year of experience in Clinical Laboratory Revenue Cycle Management (RCM) operations • Preferred: 1+ year of experience supporting prior authorization, reimbursement, billing, or benefits verification in a clinical laboratory environment • Preferred: 1+ year of experience using Microsoft Word, Microsoft Excel, and Microsoft Outlook in a healthcare reimbursement, billing, authorization, or revenue cycle 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