Job Details

Job Title: Customer Service Rep II (Prior Authorization)
Location: Remote - Georgia
Duration: 24 Months
Pay Rate: $20-$22/hr (W2)

Job Summary:
Responsible for verifying insurance coverage, managing prior authorizations, and ensuring patient access to therapies. Works closely with physician offices, payers, and internal teams to obtain approvals and resolve authorization issues.

Key Responsibilities:

• Verify patient insurance coverage and benefits
• Identify and initiate prior authorization requirements
• Submit required documentation (clinical notes, forms)
• Follow up on authorization status and ensure timely approvals
• Handle denials, appeals, and retro authorizations
• Communicate with physicians, payers, and internal stakeholders

• Experience with prior authorization and insurance verification
• Knowledge of payer processes and authorization workflows
• Familiarity with ICD-9/10 and CPT codes
• Strong communication and customer service skills
• Ability to manage multiple tasks with high attention to detail
• Proficiency in Excel and CRM systems