Prior Authorization Specialist

1 month ago


Scottsdale, Arizona, United States HonorHealth Full time

At HonorHealth, we're seeking a skilled Prior Authorization Specialist to join our Medical Management team. As a key member of our team, you'll play a vital role in reviewing requests for authorization of services and coordinating the timely completion of the authorization process.

Key Responsibilities:

  • Review referral and admission requests, verifying patient demographic and insurance information within our billing system.
  • Coordinate the PA process in MCG software, ensuring appropriate documentation for criteria is met.
  • Approve requests or send them for Medical Director/designee review if criteria and guidelines are not met.
  • Maintain a productivity PA case load of an average of 10-15 prior auth processing per day.

Requirements:

  • 1 year health plan-based prior authorization experience.
  • High School Diploma or GED required.

About HonorHealth:

HonorHealth is one of Arizona's largest nonprofit healthcare systems, serving a population of five million people in the greater Phoenix metropolitan area. We offer a diverse benefits portfolio for our full-time and part-time team members designed to help you and your family live your best lives.



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