What are the responsibilities and job description for the Authorization Specialist position at RALEIGH MEDICAL GROUP PA?
|
Title: |
Authorization Specialist - RMG |
|
Location: |
In-Office – Raleigh, NC |
|
Department: |
Infusion |
|
Shift: |
Monday - Friday FT |
Authorization Specialist – Infusion
Raleigh, NC | In-Office
Support patient access to care—every day.
Raleigh Medical Group, PA, is seeking an Authorization Specialist to support timely and accurate prior authorizations for medications, diagnostic procedures, and specialty services across the organization. This role plays an important part in ensuring patients receive access to care without unnecessary delays while maintaining strong communication with patients, providers, pharmacies, and insurance companies.
The Authorization Specialist works collaboratively with clinical and administrative teams to verify insurance requirements, monitor authorization status, and ensure accurate documentation within the EHR and practice management system..
Key Responsibilities
- Obtain prior authorizations and pre-certifications for medications, procedures, and specialty services
- Verify insurance benefits and identify authorization requirements as needed
- Monitor authorization status and follow up to prevent delays in patient care
- Communicate with patients, providers, pharmacies, and insurance companies regarding authorization requirements and updates
- Accurately document authorization and benefit information in the EHR and practice management system
- Maintain current knowledge of payer guidelines and authorization processes
- Collaborate with clinical and front office staff to coordinate patient care efficiently
- Communicate workflow updates and payer changes to appropriate team members
- Participate in departmental meetings and training sessions
- Assist with onboarding and cross-training of team members as requested
- Maintain compliance with HIPAA regulations and safeguard Protected Health Information (PHI)
- Perform other duties as assigned
Qualifications
Required:
• High school diploma or equivalent required
- Minimum of 1 year of medical office and EHR experience
- Prior authorization experience required
- Strong communication, organization, and customer service skills
- Attention to detail and ability to prioritize tasks effectively
- Ability to work independently with minimal supervision
Why Join Raleigh Medical Group?
- Meaningful work supporting patient access to care
- Collaborative, team-oriented environment
- Opportunity for professional growth and development
- Supportive leadership and training opportunities
We Offer Our Valued Employees
- Group Health, Dental, and Vision coverage
- FSA and HSA options
- Generous Paid Time Off (PTO)
- 401(k) Retirement Plan with employer matching
- Company-paid Life, Short-Term and Long-Term Disability
- Competitive pay
EEO Statement:
Raleigh Medical Group, PA is an Equal Opportunity Employer. Qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, disability, military status, or national origin, or any other characteristic protected under applicable federal, state, or local law.