What are the responsibilities and job description for the Prior Authorization Specialist-MAINE LOCATION REQUIRED position at ProSearch?
Job Title: Prior Authorization Specialist (Remote-must be commutable to Portland, Maine)
Job Type: Full-time (Monday–Friday, daytime, 40 hours/week); Temp to Hire
Location: Primarily remote; must live within commuting distance to Portland Maine for occasional onsite needs
Pay: $22-25/hr
Job Summary:
We are seeking a detail-oriented Prior Authorization Specialist for our growing speciatly healthcare client to support patients by obtaining insurance approvals for oral and IV medications, primarily in specialty care areas. This role involves working closely with healthcare providers, insurance companies, and internal teams to ensure timely authorization and continuity of care.
Key Responsibilities:
- Submit and manage prior authorization requests with insurance companies
- Communicate with providers and team members regarding authorization status, delays, or issues
- Gather and submit required clinical documentation for approvals
- Document all activity accurately in electronic medical records (EMR)
- Use insurance portals and phone communication to complete authorizations
- Review diagnoses and treatments for coverage eligibility using established guidelines
- Assist with insurance appeals when needed
- Respond to calls, messages, and inquiries from patients, providers, and insurers
- Maintain confidentiality and meet deadlines to support patient care
- Provide professional, courteous customer service at all times
- Perform additional administrative tasks as assigned
Qualifications:
- High school diploma or equivalent required
- At least 1 year of prior authorization experience (healthcare setting required; specialty care preferred)
- Familiarity with medical terminology
- Experience using electronic medical record (EMR) systems
- Strong communication and organizational skills
- Ability to multitask, problem-solve, and work independently
- Customer service experience required
- Pharmacy technician or retail pharmacy experience is a plus
Work Environment:
- Remote position with occasional onsite requirements
- Fast-paced healthcare setting requiring attention to detail and strong teamwork
Pay: $23.00 - $25.00 per hour
Benefits:
- Dental insurance
- Health insurance
- Paid time off
Work Location: Remote
Salary : $22 - $25