Nurse Prior Authorization Specialist

4 weeks ago


Indianapolis, Indiana, United States WPS Health Solutions Full time

About the Role:

We are seeking a skilled Nurse Prior Authorization Specialist to join our team at WPS Health Solutions. As a key member of our team, you will play a critical role in reviewing medical documentation for prior authorization requests submitted by healthcare providers.

Key Responsibilities:

  • Review medical documentation to ensure planned services are medically necessary based on Medicare guidelines.
  • Provide written explanations for non-affirming prior authorization requests.
  • Collaborate with healthcare providers to resolve any issues or concerns related to prior authorization requests.

Requirements:

  • Bachelor's Degree in Nursing or related field.
  • 4 or more years of experience in clinical nursing.
  • Understanding of Medicare government insurance.

What We Offer:

  • Remote work option available in approved states.
  • Performance bonus and/or merit increase opportunities.
  • 401(k) with dollar-per-dollar match up to 6% of salary.
  • Health insurance, dental insurance, and telehealth services start DAY 1.

Equal Opportunity Employer:

WPS Health Solutions is an equal opportunity employer and welcomes applications from diverse candidates. We are committed to creating an inclusive work environment that values diversity, equity, and inclusion.



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