The Prior Authorization Specialist is responsible for obtaining and processing all prior authorization requests, coordinating phone calls, entering, and tracking data from insurance providers and health plans regarding authorization, expedited reviews, and appeals. The Prior Authorization Specialist is required to document and track all communication attempts with insurance providers and health plans, follow up on all denials while working to ensure services are validated Duties and Responsibilities. o Reviews accounts, and initiate pre-authorizations, and other requirements related to managed care; route to appropriate departments as needed.o Collects demographic, insurance, and clinical information to ensure that all reimbursement requirements are met.o Assists in monitoring utilization services to assure cost effective use of medical resources through processing prior authorizations.o Assists with medical necessity documentation to expedite approvals and ensure that appropriate follow-up is performed.o Provides consistent and comprehensive information (both in writing and verbally) to facilitate approvals.o Ensures insurance carrier documentation requirements are met and authorization documentation is entered and recorded in the patient's records. o Appeals pre-authorization denials and/or set-up peer to peer reviews. o Maintains extensive knowledge and expertise of insurance companies and billing authorization requirements.o Submitting Authorization as required and ensuring all applicable codes, and information required were submitted to the appropriate payer.

• Proven experience in administrative assistance within a healthcare setting. • Proficiency in handling inbound calls and delivering clear and precise communication. • Strong skills in calendar management and scheduling appointments. • Expertise in insurance authorization processes and related documentation. • Ability to authenticate and verify insurance information accurately. • Knowledge of billing and coding standards for insurance purposes. • Familiarity with utilization management and medical necessity requirements. • Excellent organizational and multitasking abilities in a fast-paced environment.

<h3 class="rh-display-3--rich-text">TalentMatch®</h3> Robert Half is the world’s first and largest specialized talent solutions firm that connects highly qualified job seekers to opportunities at great companies. We offer contract, temporary and permanent placement solutions for finance and accounting, technology, marketing and creative, legal, and administrative and customer support roles. Robert Half works to put you in the best position to succeed. We provide access to top jobs, competitive compensation and benefits, and free online training. Stay on top of every opportunity - whenever you choose - even on the go. <a href="https://www.roberthalf.com/us/en/mobile-app" target="_blank">Download the Robert Half app</a> and get 1-tap apply, notifications of AI-matched jobs, and much more. All applicants applying for U.S. job openings must be legally authorized to work in the United States. Benefits are available to contract/temporary professionals, including medical, vision, dental, and life and disability insurance. Hired contract/temporary professionals are also eligible to enroll in our company 401(k) plan. Visit <a href="https://roberthalf.gobenefits.net/" target="_blank">roberthalf.gobenefits.net</a> for more information. © 2025 Robert Half. An Equal Opportunity Employer. M/F/Disability/Veterans. By clicking “Apply Now,” you’re agreeing to <a href="https://www.roberthalf.com/us/en/terms">Robert Half’s Terms of Use</a>.

Glen Burnie, MD
onsite
Temporary
23.00 - 25.00 USD / Hourly
The Prior Authorization Specialist is responsible for obtaining and processing all prior authorization requests, coordinating phone calls, entering, and tracking data from insurance providers and health plans regarding authorization, expedited reviews, and appeals. The Prior Authorization Specialist is required to document and track all communication attempts with insurance providers and health plans, follow up on all denials while working to ensure services are validated Duties and Responsibilities. o Reviews accounts, and initiate pre-authorizations, and other requirements related to managed care; route to appropriate departments as needed.o Collects demographic, insurance, and clinical information to ensure that all reimbursement requirements are met.o Assists in monitoring utilization services to assure cost effective use of medical resources through processing prior authorizations.o Assists with medical necessity documentation to expedite approvals and ensure that appropriate follow-up is performed.o Provides consistent and comprehensive information (both in writing and verbally) to facilitate approvals.o Ensures insurance carrier documentation requirements are met and authorization documentation is entered and recorded in the patient's records. o Appeals pre-authorization denials and/or set-up peer to peer reviews. o Maintains extensive knowledge and expertise of insurance companies and billing authorization requirements.o Submitting Authorization as required and ensuring all applicable codes, and information required were submitted to the appropriate payer.
2025-09-26T21:13:54Z

Insurance Authorization Specialist Job in Glen Burnie | Robert Half