Prior Authorization Specialist

Job title – Prior Authorization Specialist

Location – Lake Mary, FL 32746

Job type – 6 months contract with possible extension

Role Overview

We are seeking an experienced Verification of Benefits Specialist to join our healthcare operations team in Lake Mary, FL. This position is responsible for verifying insurance benefits, obtaining prior authorizations and referrals, managing denials and appeals, and maintaining accurate patient insurance and authorization records.

This is NOT a customer service position. Candidates must have prior experience in insurance benefits verification and/or prior authorization.

Key Responsibilities

• Contact insurance companies to verify patient insurance benefits and coverage.
• Initiate and follow up on prior authorizations, PCP referrals, and Letters of Agreement (LOAs) for new and ongoing services.
• Track authorization requests and follow up with insurance providers to obtain outcomes.
• File and manage appeals for denied coverage when required.
• Maintain accurate patient records related to benefits, coordination of benefits, authorizations, denials, appeals, outcomes, and insurance communications.
• Coordinate with internal departments to obtain information required for benefit verification, authorization, and appeals.
• Communicate authorization status and coverage information to patients and relevant internal teams.
• Prepare and communicate patient financial responsibility estimates and collect applicable co-pays.
• Apply company procedures, payer guidelines, and contracted/non-contracted requirements when processing cases.
• Review and process incoming correspondence and documentation and update patient records based on outcomes.
• Perform other related duties as assigned.

Required Qualifications

• Minimum 1 year of experience in insurance benefits verification and/or prior authorization.
• Prior experience working with health insurance benefits and authorizations is required.
• High School Diploma or GED equivalent.
• Knowledge of Medicare rules and regulations.
• Understanding of managed care, benefits, and authorization processes.
• Advanced proficiency with Microsoft Office, including Excel and Outlook.
• Strong verbal and written communication skills.
• Ability to communicate professionally with insurance companies, patients, and internal departments.
• Strong attention to detail and accuracy.
• Ability to work effectively under pressure and meet strict deadlines.

Preferred Qualifications

• 2+ years of experience in insurance benefits verification, prior authorization, collections, or managed care contracting.
• Experience working with healthcare providers, medical practices, hospitals, or insurance organizations.
• Experience handling insurance denials, appeals, referrals, and authorization follow-up.
• Familiarity with practice management or healthcare information systems.

Select Source International (SSI) is a distinguished workforce solutions provider with nearly 25 years of experience delivering top-tier staffing, recruiting, and managed services. Based in Minneapolis, Minnesota, SSI has established itself as a global leader, serving a broad, diverse clientele across industries with unwavering dedication and excellence.

As a trusted partner, we bring a wealth of expertise and best-in-business differentiators to comprehensively support your evolving workforce needs. SSI is ISO 9001, ISO 14001, and SOC 2 Type II certified, underscoring our strict commitment to quality, environmental responsibility, and data security. Our industry-leading capabilities are further validated by numerous awards in sustainability and supplier diversity.