Authorization Representative

Description Position at PRN Physical Therapy Job Title Physical Rehabilitation Network (PRN) and its Family of Brands is seeking to recruit & hire a Authorization Representative. About Us PRN brings together some of the most trusted PT brands across the West and Central U.S. Whether in the clinic or behind the scenes, we’re all about personalized care, smart clinical insight, and making every patient feel supported from start to finish. About the Role The Authorization Representative is responsible for obtaining, verifying, and documenting insurance authorizations and pre-certifications for medical procedures, services, or medications. This role ensures compliance with payer requirements, prevents claim denials, and supports efficient patient access to care. Duties & Responsibilities Insurance Verification & Authorization Secure prior authorizations and pre-certifications from insurance companies within required timeframes. Review medical necessity guidelines and payer policies to determine required documentation. Communicate with providers, clinical staff, and insurance carriers to obtain required details for authorization approval. Documentation & Data Entry Accurately document authorization numbers, effective dates, status updates, and payer information in electronic health record (EHR) or practice management systems. Maintain organized and compliant records according to HIPAA standards. Communication & Coordination Provide updates to scheduling, billing, and clinical teams regarding authorization status. Collaborate with clinical teams to support appeals or additional documentation requests. Compliance & Quality Assurance Adhere to federal, state, and payer-specific regulations. Monitor policy changes from insurance carriers and notify internal teams as needed. Assist in resolving claim denials related to missing or incorrect authorizations. Skills & Qualifications High school diploma or equivalent Experience in healthcare authorization, medical billing, patient access, or insurance verification Strong understanding of medical terminology, CPT/ICD-10 codes, and insurance regulations Excellent communication, organization, and problem-solving skills Proficiency with EHR systems, payer portals, and standard office software Experience working with multiple insurance payers (Medicare, Medicaid, commercial plans, etc.) preferred Benefits & Perks We offer a comprehensive and competitive compensation package designed to support both personal and professional well being. Team members enjoy full scale benefits—including robust Medical, Vision, and Dental plans—along with paid time off, clinical incentive opportunities, and student loan repayment options. We are committed to your continued growth and success, providing professional development resources and ongoing clinical education support. At PRN, you’ll be part of a supportive, mission driven environment dedicated to excellence in patient care and the success of every member of our team. Note: This job description is a general outline of responsibilities and requirements. Specific duties may vary based on the needs of management.