Provider Customer Service Representative / Prior Authorization Specialist / Member Service / Utilization Review Specialist
Job Title: Prior Authorization Specialist / Provider CSR Location: Remote (Work from Home) Employment Type: Full-Time Pay Rate: $17/hour Work Schedule This is a full-time role requiring 40 hours per week Candidates must be flexible to work Saturday shifts as part of the weekly schedule Operational Hours: Monday to Sunday, 7:00 AM – 7:00 PM CST (shift will be assigned within this window) Training Schedule: Monday to Friday, 9:30 AM – 6:00 PM CST Job Summary We are seeking a detail-oriented and experienced Pre-Authorization Specialist to support provider enablement activities. The ideal candidate will have a strong background in healthcare operations, authorization processes, and administrative support, along with the ability to work efficiently in a remote environment.
Key Responsibilities
Handle pre-authorization processes and related back-office operations Perform both backend administrative tasks and outbound/inbound calling activities as required Work with medical platforms and authorization systems to process requests Review and verify healthcare documentation and coding (ICD-10, CPT) Coordinate with internal teams and providers to ensure timely approvals Maintain accurate records and documentation Perform administrative and clerical support tasks as needed Utilize multiple systems and applications efficiently in a remote setup Basic Requirements High School Diploma or equivalent (documentation required) Minimum 1 year of work-from-home experience with high-speed internet At least 1 year of experience with back-office medical platforms and/or authorization systems Minimum 1 year of experience in the healthcare industry (hospital, physician’s office, or clinical setting) Working knowledge of medical terminology, ICD-10 and CPT codes, Medicare and/or Medicaid services Professional experience in clerical or administrative support roles Ability to quickly learn and adapt to new systems and applications Proficiency in using computers/laptops and tools such as Outlook, Microsoft Teams (including screen sharing), Word, and Excel