Prior Authorization Specialist

Logan Health

Prior Authorization Specialist securing medical procedure authorizations for Logan Health, a Montana healthcare provider. Submitting coding and records, resolving denials, and supporting patient revenue-cycle operations remotely.

Posted 8/19/2026full-timeRemote • Arizona, Colorado, Florida, Hawaii, Idaho, Illinois, Kansas, Minnesota, Missouri, Montana, North Carolina, Ohio, Oregon, Tennessee, Texas, Virginia, Washington • 🇺🇸 United StatesJuniorMid-LevelWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in obtaining prior authorizations, verifying patient information, and ensuring compliance with HIPAA regulations. Proficient in medical coding, particularly ICD-9 and CPT codes, with strong organizational and communication skills to manage sensitive situations effectively.

Highest-signal resume keywords

Prior Authorization ExperienceICD-9 And CPT Coding KnowledgeHIPAA ComplianceMedical Terminology ProficiencyMicrosoft Office Suite Proficiency

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Prior AuthorizationCPT CodingICD-9 CodingMedical TerminologyClaims ProceduresReimbursement KnowledgeAttention To DetailCritical ThinkingDocumentation SkillsOrganizational Skills

Soft Skills

Excellent Communication SkillsInterpersonal SkillsProfessionalismAbility To Function IndependentlyTeam Collaboration

Tools & Technologies

Microsoft Office SuiteMeditech

Industry Keywords

HealthcareInsurance RequirementsManaged Care CoveragePatient FlowRevenue Cycle

About the role

Key responsibilities & impact

Obtain accurate prior authorizations for facility and professional charges related to scheduled patient appointments
Submit CPT and HCPCS codes and medical records to insurance carriers to expedite authorization requests
Verify patient demographics and medical information while ensuring HIPAA compliance
Review information accuracy and completeness and confirm supporting documentation
Collaborate with relevant stakeholders
Prioritize incoming authorization requests according to department procedures
Confirm CPT and ICD-10 diagnosis accuracy in procedure orders
Maintain intranet resources related to payer requirements
Contact patients and/or clinics when authorization is not obtained before the date of service
Initiate retro authorization requests and resolve authorization denials
Prepare, submit, and track appeals
Document all actions taken in patient accounts
Communicate billing, authorization, insurance, backlog, problematic account, and documentation issues to leadership
Adapt to changing circumstances to support patient flow
Maintain professionalism, integrity, confidentiality, and accurate attendance

Requirements

What you’ll need

Minimum of two (2) years’ experience in an acute care hospital, specialty clinic and/or medical billing office obtaining pre-certifications and/or prior-authorizations
Knowledge of commercial and government insurance requirements
Knowledge of medical terminology and rules and regulations governing the handling of private health information
Working knowledge of ICD-9 and CPT codes
Understanding of reimbursement and claims procedures and their direct impact on the revenue cycle
Working knowledge of Microsoft Office Suite and ability to learn other software as needed
Excellent verbal and written English communication skills
Excellent organizational skills, attention to detail, critical thinking, and ability to set priorities
Ability to function independently and as part of a team
Excellent interpersonal skills and ability to manage sensitive and confidential situations with tact, professionalism, and diplomacy
Must reside in Arizona, Arkansas, Colorado, Florida, Hawaii, Idaho, Illinois, Indiana, Kansas, Michigan, Missouri, Montana, Minnesota, North Carolina, Ohio, Oregon, Tennessee, Texas, Virginia, or Washington
Associate or Bachelor’s degree preferred
Meditech experience preferred
Knowledge of managed care coverage and medical coding preferred

Benefits

Comp & perks

Comprehensive benefits
Opportunities for professional growth
Full-time remote work
Pre-employment screening includes criminal background check, reference checks, drug screening, health and immunizations screening, and physical demand review/screening