Job description
Raventra Health is a medical services company providing outsourced billing, coding, and claims processing solutions for provider groups and hospitals. As a Prior Authorization Specialist, you will coordinate prior authorization requests for scheduled procedures, treatments, and services on behalf of provider clients. You will work with payer portals, provider teams, and clinical documentation to help secure timely approvals and resolve authorization-related issues.
WHAT YOU WILL DO
Submit and track prior authorization requests across multiple insurance payers
Gather and review clinical documentation required to support authorization requests
Communicate with provider teams to obtain missing information or documentation
Follow up with payers on pending requests and monitor authorization status through resolution
Identify authorization issues and pursue reconsiderations or appeals when requests are denied
Maintain accurate records of authorization requests, decisions, and follow-up actions
Stay current on payer-specific authorization requirements and communicate relevant changes to the team
Escalate delays, complex cases, and potential barriers to timely patient care when appropriate
WHAT WE ARE LOOKING FOR
2+ years of experience in prior authorization, insurance verification, medical billing, or a related healthcare role
Experience working with insurance payer portals and authorization requirements
Ability to understand and interpret clinical documentation
Strong attention to detail and ability to manage multiple authorization requests simultaneously
Persistence and strong follow-through when working through multi-step authorization or appeal processes
Strong written and verbal communication skills when working with providers, payers, and internal teams
Ability to work independently while meeting productivity and turnaround expectations
HIPAA-compliant private workspace and ability to work effectively in a fully remote role
NICE TO HAVE
Experience with specialty-specific prior authorizations
Pharmacy prior authorization experience
Clinical or healthcare background
Experience with an EMR system such as Epic, Athena, or eClinicalWorks
Experience handling authorization denials, reconsiderations, or appeals
COMPENSATION AND BENEFITS
Compensation will be discussed during the interview and will reflect the candidate’s experience, qualifications, and relevant healthcare revenue cycle expertise.
Benefits and additional employment details will be discussed during the hiring process.
HIRING PROCESS
Application review → introductory conversation → hiring manager interview → offer.
EQUAL OPPORTUNITY
Raventra Health is an equal opportunity employer. We consider all qualified applicants without regard to race, colour, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or any other protected characteristic. If you need an accommodation at any stage of the hiring process, please contact us and we will work with you to provide appropriate support.
Location: Remote
Originally posted on Himalayas
Who can apply
Eligible countries: United States. Accepted UTC offsets: UTC-10, UTC-9, UTC-8, UTC-7, UTC-6, UTC-5, UTC+14. Review the full description for employer-specific work authorization, residency and schedule requirements.