Prior Authorization Specialist / Clerical Float

Company Overview
We are seeking an experienced Prior Authorizations Specialist (Clerical Float) to join our team! We’re looking for someone warm, positive, and patient—someone who brings empathy and professionalism to every interaction. Strong customer service skills and attention to detail!

We are a very successful but extremely busy practice, and each team member plays a vital role in supporting our patients. We need individuals who are confident, resilient, and able to maintain composure and compassion in a fast-paced environment.

Job Summary
The Patient Care Coordination & Authorization Specialist plays a key role in supporting preventive care initiatives, medication authorization workflows, and continuity of care. This position primarily manages Prolia insurance verification and prior authorizations as well as Aledade reporting for Annual Wellness Visits (AWV), hypertension (HTN), and care programs, ensuring patients are properly tracked, scheduled, and referred.

This role also provides secondary support as backup for the Communications Team as operational needs require. The position requires strong attention to detail, familiarity with Epic, and the ability to manage multiple workflows across patient populations.

Duties
Prolia Insurance Verification & Prior Authorization

• Verify insurance coverage for Prolia injections
• Submit and track Prolia-related prior authorization requests
• Follow up on PA determinations and communicate status internally as needed
• Ensure documentation is complete and accurate prior to scheduling or administration
• Maintain organized tracking of Prolia patients and authorization timeline

Aledade Reporting & Care Program Coordination

• Review Aledade reports for:
• Annual Wellness Visits (AWV)
• Hypertension (HTN) management
• Care management program eligibility
• Monitor patients identified in reports to ensure appropriate appointments are scheduled
• Track referrals for care programs and confirm completion or next steps
• Coordinate with clinical and communication teams to close care gaps
• Maintain accurate tracking and follow-up documentation within Epic

Communications Team Support

• Provide backup coverage for incoming patient phone calls
• Assist with appointment scheduling, rescheduling, and cancellations
• Send appointment confirmations and outreach messages via Klara
• Support Communication Team in-baskets and Patient Action Requests as needed
• Help ensure continuity of patient communication during high-volume or coverage gaps

Requirements

• Proven experience in a medical office setting, preferably within managed care or insurance verification roles.
• Familiarity with HIPAA regulations to ensure patient privacy and data security.
• Experience with medical records management and insurance verification processes.
• Strong organizational skills with the ability to multitask efficiently in a fast-paced environment.
• Excellent communication skills for effective interaction with patients, providers, insurers, and team members.

Pay: From $20.00 per hour

Expected hours: 40.0 per week

Benefits:

• 401(k)
• 401(k) matching
• Dental insurance
• Employee discount
• Health insurance
• Paid time off
• Vision insurance

Work Location: In person

Salary : $20