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OA
Orthopaedic and Sports Medicine Center
Prior Authorization Specialist
Career Insights for Medical Claims Processor / Representative
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Based on Kansas data
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What they do
A Medical Claims Processor or Representative reviews and processes medical insurance claims and determines whether an insurance policy will cover a medical procedure. Gathers information from policy holders and organizes insurance files; may process checks with payments to policy holders when a medical claim is approved.
$42,624 / year median in Kansas
-4% projected decline
Job Description
Prior Authorization Specialist - Join Manhattan, KS's Premier Orthopaedic Practice! OSMC | Manhattan, KS | Full-Time Why OSMC? For over 40 years, OSMC has been the trusted name in orthopaedic care in Manhattan and the surrounding communities — and we're proud to serve as the team orthopaedic doctor for K-State athletics! We're a physician-owned practice built on teamwork, excellence, and genuine care for our patients and our people. If you're looking for a stable, rewarding career with a team that feels like family, we'd love to meet you. The Role We're hiring a detail-oriented Prior Authorization Specialist to manage the full authorization process — from request to approval — helping ensure our patients get the care they need without delay. This is a great fit for someone who loves problem-solving, thrives on organization, and takes pride in getting things right the first time. What You'll Do Receive and track prior authorization requests via EHR, phone, and fax Verify authorization and pre-service requirements are met Submit referrals and medical records to insurance carriers Assist with medical necessity documentation to speed up approvals Review and appeal denied authorizations when appropriate Research and resolve missing or invalid authorization information Maintain up-to-date payer files and authorization requirements Deliver outstanding service to patients, providers, and coworkers alike Spot and report trends impacting billing and reimbursement What We're Looking For High school diploma or equivalent 1-2 years of related experience preferred Working knowledge of medical terminology, billing, and insurance Proficient in MS Word & Excel Strong organizational skills, attention to detail, and time management A friendly, professional phone and customer service manner Comfortable multitasking in a fast-paced clinical setting What We Offer ✔ 3 weeks paid time off ✔ 40 hours paid volunteer time off ✔ Medical, dental & vision insurance ✔ Flexible spending account ✔ 401(k) ✔ Life insurance ✔ Short- and long-term disability