[Remote] Healthcare Authorization Support Specialist

Note: The job is a remote job and is open to candidates in USA. Consulting Solutions is seeking a Healthcare Authorization Support Specialist to process Medicare and health insurance requests and support authorization and pre-certification workflows. The role verifies eligibility and benefits, reviews documentation, and coordinates with nursing teams to ensure timely and accurate processing.

Responsibilities

• Process requests, inquiries, and transactions received by phone, email, fax, and mail
• Review requests and supporting documentation for accuracy and completeness
• Verify member eligibility, benefits, provider information, and authorization requirements
• Enter and maintain service requests, research missing or incorrect information, and route unresolved issues to the appropriate team
• Triage and assign incoming inquiries efficiently to ensure timely follow-up
• Document interactions and provide verbal or written authorization outcome notifications to members and providers
• Analyze inquiry trends and share feedback with team leads regarding training needs and provider education
• Conduct monthly peer audits as required

Skills

• High school diploma or GED
• At least 3 years of relevant healthcare, health insurance, or related experience
• Medicare experience
• Familiarity with health insurance processes and Microsoft Office applications
• Strong attention to detail, organizational skills, and communication abilities
• Experience with triage, referral processing, or authorization support
• Pharmaceutical knowledge or experience
• Experience working with prior authorization or pre-certification processes

Benefits

• Training includes approximately two weeks of classroom instruction, followed by two to three weeks of job shadowing and hands-on training.

Company Overview