Advanced Authorization Specialist

The Advanced Authorization Specialist is responsible for obtaining highly complex authorizations for in-patient and out-patient services, requiring a thorough understanding of commercial and government payors, coordination of benefits, and medical necessity policies. The role involves interpreting complex medical records, communicating with clinic staff and insurance companies, and collaborating with denial management teams to review denials and assess opportunities for retroactive authorizations. This position plays a key role in managing high-volume stat requests and ensuring timely approvals for critical treatments and procedures.