The specialist will manage the end-to-end authorization lifecycle, including submitting requests, validating clinical documentation, and tracking status through payer portals. They will also handle inbound inquiries from healthcare professionals and patients regarding billing, benefits, and account details.
Neolytix is looking for a Healthcare Associate who already knows the prior authorization world inside and out — in a healthcare BPO, a hospital, a clinic, a payer-services team, or a revenue cycle department — and can step in already knowing how the work goes.
WHAT YOU WILL DO:
Own the authorization lifecycle
Submit authorization requests through payer portals and other approved channels, and track them through to resolution.
Collect and validate clinical documentation and patient information needed to support each request.
Manage payer follow-up, status tracking, escalations, and deadlines so nothing slips through the cracks.
Support peer-to-peer reviews, denials, reconsiderations, and appeals when a request needs a second look.
Navigate the systems that keep care moving
Work confidently across EHR/EMR systems, payer portals, communication tools, and multi-queue work environments.
Enter data accurately, spot errors before they become problems, complete forms correctly the first time, and keep documentation audit-ready.
Take inbound calls from healthcare professionals — nurses, physicians, and office staff — with authorization-related questions, and professionally assist insurance members who need help or clarification.
Explain billing, benefits, and account details to callers clearly and professionally, verifying caller and account information against records before processing any request.
Keep the queue under control
Manage a high-volume, multi-queue workload with strong organization, time prioritization, and SLA awareness.
Document every interaction completely and accurately, and resolve issues patiently — including with callers who need extra time or a simpler explanation.
Maintain confidentiality and professionalism at all times, and complete required HIPAA and security training.
WHY APPLY? Gain a meaningful work, as you're the person standing between a patient and the care they need. This is a role built around the skills you already have. If prior authorization is a language you already speak fluently, we'd love to hear from you!
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