58 applicants

Company

Synapticure Inc. · 16 hours ago

Prior Authorization Specialist

United States

Full-time

Remote

Entry Level

$42K/yr - $45K/yr

2+ years exp

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Responsibilities

Collaborate with insurers to obtain pre-authorizations for condition-specific medications, diagnostic procedures and treatments, and support patients in navigating barriers / coverage and disputes.

Submit prior authorization requests for medical procedures, diagnostic tests, treatments, and medications as required by insurance providers.

Gather, review, and submit all necessary clinical documentation to support authorization requests, ensuring accuracy and completeness.

Communicate with insurance representatives to clarify requirements, resolve authorization denials, and follow up on pending approvals.

Collaborate with physicians, nurses, and other clinical staff to obtain additional clinical information or documentation required by insurance companies.

Inform patients about the status of their authorization requests, answer questions regarding coverage, and provide guidance on next steps.

Maintain accurate and detailed records of all prior authorization requests, outcomes, and patient information in compliance with HIPAA regulations.

Stay updated on changes in insurance policies, state and federal regulations, and organizational policies affecting prior authorizations and reimbursement.

Qualification

Find out how your skills align with this job's requirements. If anything seems off, you can easily click on the tags to select or unselect skills to reflect your actual expertise.

Prior AuthorizationsInsurance CoordinationHealthcare Insurance SystemsCase ManagementMedical TerminologyPatient AdvocacyProblem-Solving Mindset

Required

2+ years of experience in prior authorizations, insurance coordination, or case management in a healthcare setting

Strong communication skills with the ability to explain complex medical and insurance information in an empathetic, patient-friendly manner

Passion for patient advocacy with a problem-solving mindset, focusing on overcoming challenges to accessing care

Ability to work effectively both independently and as part of a multidisciplinary team, including neurologists, health systems, independent providers, and insurers

Understanding of healthcare insurance systems, especially for complex, long-term treatments

Maintain accurate and detailed records of all prior authorization requests, outcomes, and patient information in compliance with HIPAA regulations

Stay updated on changes in insurance policies, state and federal regulations, and organizational policies affecting prior authorizations and reimbursement

Preferred

Preferred experience in neurology, radiology or infusion settings

Preferred clinical experience and understanding of medical terminology

Benefits

Remote-first design with work from home stipend

Competitive compensation with an annual bonus opportunity

401(k) with matching contribution from day 1

Medical, Dental and Vision coverage for you and your family

Life insurance and Disability

Generous sick leave and paid time off

Fast growth company with opportunities to progress in your career

Company

Synapticure Inc.

Synapticure brings expert virtual care to individuals and caregivers living with neurodegenerative diseases, including Parkinson's, Alzheimer's and related dementia, ALS, and more conditions.

Founded in 2019

Chicago, Illinois, USA

11-50 employees