PRIOR AUTHORIZATION SPECIALIST

Raventra Health is a medical services company providing outsourced billing, coding, and claims processing solutions for provider groups and hospitals. As a Prior Authorization Specialist, you will coordinate prior authorization requests for scheduled procedures, treatments, and services on behalf of provider clients. You will work with payer portals, provider teams, and clinical documentation to help secure timely approvals and resolve authorization-related issues.

WHAT YOU WILL DO

Submit and track prior authorization requests across multiple insurance payers

Gather and review clinical documentation required to support authorization requests

Communicate with provider teams to obtain missing information or documentation

Follow up with payers on pending requests and monitor authorization status through resolution

Identify authorization issues and pursue reconsiderations or appeals when requests are denied

Maintain accurate records of authorization requests, decisions, and follow-up actions

Stay current on payer-specific authorization requirements and communicate relevant changes to the team

Escalate delays, complex cases, and potential barriers to timely patient care when appropriate

WHAT WE ARE LOOKING FOR

2+ years of experience in prior authorization, insurance verification, medical billing, or a related healthcare role

Experience working with insurance payer portals and authorization requirements

Ability to understand and interpret clinical documentation

Strong attention to detail and ability to manage multiple authorization requests simultaneously

Persistence and strong follow-through when working through multi-step authorization or appeal processes

Strong written and verbal communication skills when working with providers, payers, and internal teams

Ability to work independently while meeting productivity and turnaround expectations

HIPAA-compliant private workspace and ability to work effectively in a fully remote role

NICE TO HAVE

Experience with specialty-specific prior authorizations

Pharmacy prior authorization experience

Clinical or healthcare background

Experience with an EMR system such as Epic, Athena, or eClinicalWorks

Experience handling authorization denials, reconsiderations, or appeals

COMPENSATION AND BENEFITS

Compensation will be discussed during the interview and will reflect the candidate’s experience, qualifications, and relevant healthcare revenue cycle expertise.

Benefits and additional employment details will be discussed during the hiring process.

HIRING PROCESS

Application review → introductory conversation → hiring manager interview → offer.

EQUAL OPPORTUNITY

Raventra Health is an equal opportunity employer. We consider all qualified applicants without regard to race, colour, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or any other protected characteristic. If you need an accommodation at any stage of the hiring process, please contact us and we will work with you to provide appropriate support.

Location: Remote

Originally posted on Himalayas