Authorization Specialist

Regional West Medical Center is seeking an Authorization Specialist to support timely, accurate prior authorization for patient services. This role is responsible for obtaining authorizations for surgeries, diagnostic and cardiac imaging, procedures, prescription medications, VA services, select durable medical equipment, and outside referrals.

The Authorization Specialist plays a key role in ensuring services are approved, properly documented, and aligned with payer requirementssupporting seamless patient care and revenue integrity.

EducationHigh school diploma or equivalent requiredExperience & SkillsTwo or more years of healthcare experience preferredKnowledge of insurance processes and medical terminology preferredStrong attention to detail and accuracyAbility to multitask and prioritize in a fastpaced environmentBasic computer skills and comfort with electronic health recordsExcellent customer service, communication, and problemsolving skillsCommitment to compliance, confidentiality, and patientcentered careKey ResponsibilitiesObtain prior authorizations for surgeries, diagnostic imaging, procedures, medications, VA services, DME, and referralsReceive and process orders via the electronic health record or fax according to priority statusVerify patient insurance eligibility and benefitsInitiate authorizations through payer portals, phone, or fax, providing required clinical documentationDocument authorizations, approvals, denials, appeals, and communications in the electronic health record per protocolFollow Prior Authorization policies, workflows, and quality metricsIdentify and resolve authorization discrepancies promptlyCoordinate with providers, clinical staff, and internal teams to ensure services align with approved authorizationsMaintain confidentiality and comply with HIPAA and organizational policiesAdapt to changing workflows and departmental needsWhy Regional WestTuition reimbursement and professional development opportunitiesCompetitive compensation and comprehensive benefitsCollaborative team focused on Mission, Values and VisionA conditional job offer is contingent upon successfully passing a pre-employment drug test and background checks. A Physical Capacity Profile may be required for some positions.