Prior Authorization Specialist

Labcorp is a global leader in laboratory services, providing the insights and answers that help healthcare providers, patients, researchers, pharmaceutical companies and health systems make confident decisions and improve outcomes. Through our unparalleled science, data, technology and laboratory network, we advance diagnostics, accelerate innovation and help address some of the world’s most important health challenges. As we shape the future of healthcare, we are leveraging advanced technologies, intelligent digital solutions and data-driven innovation across our operations to enhance how work gets done and deliver greater value to customers and patients.

With our global scale and deep expertise, you’ll have the opportunity to do meaningful work, grow your career and make a real impact on people’s health around the world. Together, we’re improving health and improving lives.

Labcorp is a global leader in diagnostic testing and drug development solutions, helping healthcare providers, researchers, and patients make informed decisions that advance care. Join us in our mission to improve health and improve lives.

Labcorp is seeking a REMOTE Prior Authorization Specialist to join our team!

Work Schedule:

Monday – Friday; 8:00am-5:00pm EST

• Review incoming orders to verify completeness and accuracy of documentation required for prior authorization submission.
• Initiate and manage prior authorization requests in accordance with payer requirements and medical policies.
• Work directly with vendors, payers, and insurance representatives to facilitate successful prior authorization submissions.
• Monitor prior authorization request status, track pending cases, and perform follow-up activities to support timely determinations.
• Review insurance policies, medical policies, and payer guidelines to ensure authorization requests meet applicable requirements.
• Perform benefit investigations to support reimbursement and pre-billing activities.

• Respond to billing-related inquiries received through phone, email, chat, portal, and other communication channels.
• Provide prior authorization status updates and requirements information to providers, patients, and insurance representatives.
• Support resolution of authorization-related and billing-related issues.

• Maintain accurate records of prior authorization requests, approvals, denials, and related activities within designated databases and systems.
• Enter and maintain authorization, coverage, and benefits information in applicable platforms.
• Identify process improvement opportunities related to authorization and reimbursement workflows.
• Participate in projects and initiatives supporting operational improvements and business objectives.
• Maintain productivity and service-level expectations while managing assigned work schedules and changing business priorities.

• Requires a High School or equivalent with minimum 2 years’ relevant experience. Successful completion of the Labcorp training sessions including Medical Terminology, Anatomy and Physiology along with passing the assessment of skill.

• Associate degree in Healthcare Administration, Business Administration, Health Information Management, or a healthcare-related field.
• 1 or more years of experience in Clinical Laboratory Revenue Cycle Management (RCM) operations.
• 1 or more years of experience supporting prior authorization, reimbursement, billing, or benefits verification activities within a clinical laboratory environment.
• 1 or more years of experience using Microsoft Word, Microsoft Excel, and Microsoft Outlook in a healthcare reimbursement, billing, authorization, or…