Pre Authorization Specialist

Description Position Summary

This position is part of an expanding administrative team supporting a growing independently owned medical practice in Anchorage, Alaska. The Pre-Authorization Specialist (PAS) is responsible for coordinating, submitting, and tracking prior authorizations for specialty therapies and related treatments. This role ensures timely approvals to support uninterrupted patient care and collaborates closely with clinical staff, providers, payers, and patients. The PAS plays a critical role in streamlining the treatment pathway and preventing administrative delays.

• Prepare, submit, and manage prior authorizations for specialty therapies and related services.
• Review patient benefits and insurance requirements to determine authorization needs.
• Clearly and concisely communicate insurance coverage and patient assistance program eligibility to patients.
• Communicate with insurance companies and patient assistance programs to clarify requirements, provide additional documentation, and resolve discrepancies.
• Coordinate with billing team to streamline patient assistance program claim submission and payment processes.
• Track authorization statuses, document outcomes, and ensure timely follow-up to avoid treatment delays.
• Coordinate with providers, clinical staff, and pharmacy partners to ensure documentation is complete and accurate for submissions.
• Notify clinical teams of approval outcomes and assist in scheduling services once authorization is secured.
• Maintain current knowledge of payer policies, formularies, step therapy requirements, and appeal processes.
• Initiate and support appeals for denied authorizations, including drafting appeal letters and gathering necessary clinical justification.
• Provide patients with clear updates regarding the status of approvals and expected timelines.
• Ensure compliance with HIPAA regulations and internal protocols when handling patient information.
• Perform other duties as assigned.

• Prior experience with medical prior authorizations required.
• Strong understanding of commercial, Medicare, and Medicaid authorization processes.
• Excellent communication skills for interacting with insurers, providers, and patients.
• High attention to detail, accuracy, and documentation quality.
• Ability to manage multiple authorizations simultaneously and maintain timely follow-through.
• Familiarity with electronic health records (EHR) and payer portals.

• Prior experience with specialty therapy authorizations.
• Experience with patient assistance program eligibility, enrollment, and claim submission.
• Experience in a specialty or multi-provider medical practice setting.

• Fast-paced medical setting with strong collaboration between administrative and clinical teams.
• Role may involve both independent work and frequent interaction with providers, clinical staff, and patients.