Prior Authorization Specialist

Company Description

TechLoom Global connects industry-leading companies across various sectors with top-tier global talent. Our expertise spans a wide range of functions, including sales development, product and engineering, marketing, operations, customer success, finance, and administrative support. As a TechLoom Global team member, you become part of a network of high-caliber professionals delivering real impact for forward-thinking companies navigating today's dynamic and competitive landscape.

Role Description

We are seeking an Authorization Specialist to support the front-end revenue cycle for a growing multi-specialty behavioral health provider. This is an entry-level, hands-on role — ideal for someone early in their healthcare RCM career who wants to build deep expertise in prior authorizations, eligibility verification, and payer coordination.

You'll work closely with the client's clinical and billing teams in a fully remote environment, making sure every scheduled service has a valid, current authorization before it happens — not after. Accuracy and follow-through matter more than speed here: a missed or incorrect auth becomes a denied claim down the line.

This role is ideal for someone detail-oriented, comfortable navigating multiple payer portals and systems, and eager to grow into deeper behavioral health / ABA authorization expertise over time.

Responsibilities

• Check patient eligibility and benefits ahead of scheduled services
• Submit prior authorization requests via payer portals, phone, and fax
• Track authorization status and ensure all scheduled services have valid, current authorizations on file
• Document accurately in EHR/PM systems with minimal correction needed during audits
• Communicate clearly and professionally with providers, families, and payer representatives
• Manage a high-volume, deadline-driven workload across multiple systems (EHR, payer portals, spreadsheets, Monday.com)
• Maintain proper handling of PHI in accordance with HIPAA
• Escalate missing documentation or medical necessity gaps proactively to avoid avoidable denials

Qualifications

• 1–2 years of experience in healthcare prior authorization, insurance verification, or front-end revenue cycle (behavioral health/ABA experience a plus)
• Basic understanding of commercial and Medicaid benefits and medical necessity requirements
• Strong attention to detail and accuracy in data entry and documentation
• Good written and verbal communication skills
• Strong organization and time-management skills in a high-volume environment
• High school diploma or equivalent (medical office or billing coursework preferred)

Hands-on experience with:

• Payer portals, phone, and fax-based authorization submission
• EHR/PM systems and eligibility/benefits verification tools
• Workflow tools such as Monday.com
• HIPAA-compliant PHI handling