Prior Authorization Specialist

Job overview

The Prior Authorization Specialist role is onsite in Pender, NE, with a Monday–Friday schedule from 8:00 a.m. to 4:30 p.m. and a minimum of 20 hours per week. Compensation is not specified. The position supports an effective prior authorization program to help patients receive timely and appropriate medical services. The specialist coordinates insurance approvals for procedures, treatments, and hospital admissions, ensuring authorization information is accurate and available before services are provided. The role connects patients, providers, payers, and hospital departments to keep authorization workflows moving and communicate outcomes and financial responsibility questions.

What you'll do

• Verify insurance coverage and benefits
• obtain, process, and document prior authorizations in the EMR
• submit supporting medical records and information to payers
• monitor payer trends and prioritize urgent cases
• ensure authorizations are in place before services
• maintain payer website information
• communicate authorization needs to departments and staff
• liaise with hospital departments, physician offices, and patients
• obtain clinical information for CPT/ICD-10 codes
• monitor approvals and denials and coordinate with Patient Accounting and the Revenue Cycle Action Team
• connect patients or guarantors with a Financial Counselor for estimates.

What we're looking for

Skills & competencies

prior authorization specialist

insurance verification

healthcare workflows

medical records

emr

cpt and icd-10

payer coordination

patient communication

revenue cycle

monday–friday

pender ne

Work arrangement

• Weekend coverage required

Why this role

Minimum 20 hours per week; Monday–Friday, 8:00 a.m.–4:30 p.m.; high school diploma or equivalent and experience in insurance verification or prior authorizations required; no certificates or licenses listed.

About the employer

Pender Community Health is hiring for this role. Industry: All Other Outpatient Care Centers. Sector: 62.