Patient Account Representative - 252276

Job Title: Prior Authorization Specialist (Remote)Location: New York (Remote – Must Work EST Hours)Schedule: Monday–Friday, 8:30 AM – 6:00 PM EST (includes 1-hour unpaid lunch)Job SummaryWe are seeking an experienced Prior Authorization Specialist to join a growing healthcare organization based in New York. This is a fully remote role supporting outpatient providers, focused on ensuring timely and accurate prior authorizations across a range of services.This position is ideal for candidates who have hands-on prior authorization experience on the provider side (not hospital or insurance) and are comfortable working in a fast-paced, high-volume environment.Key ResponsibilitiesReview physician orders and medical documentation for accuracy and completenessSubmit prior authorization requests for cardiology services and related specialties, including:EchocardiogramsStress testsCardiac catheterizationsNuclear imagingSpecialty medicationsCommunicate with insurance carriers to obtain approvals and resolve authorization denialsTrack, monitor, and follow up on outstanding authorizations to prevent delays in patient careAccurately document all authorization activities and maintain compliance with payer requirementsWork with both commercial and government insurance plansMeet productivity goals of approximately 40 claims per day (subject to adjustment during onboarding period)Required QualificationsMinimum of 3+ years of prior authorization experienceDirect experience working with commercial insurance plansExperience supporting outpatient provider settings (not hospital-based or payer-side roles)Strong computer skills and ability to navigate multiple systems efficientlyAbility to manage high-volume workloads and meet daily productivity targetsPreferred QualificationsExperience with eClinicalWorks (eCW) or similar EMR systemsFamiliarity with cardiology or specialty procedure authorizationsWhat We OfferFully remote work environmentConsistent weekday schedule with no weekendsOpportunity to work with a collaborative, patient-focused teamStable, high-impact role supporting timely patient care access