Eligibility & Prior Authorization Specialist | Healthcare | Remote

Role Name: Eligibility & Prior Authorization Specialist

Full-time (40 hours a week)

Mon-Fri 8am-5pm MST (Arizona) no daylight savings 

Client overview

This is a growing US-based healthcare management services organization that partners with and operates multiple independent primary care practices under a unified management model. They handle the administrative and operational backbone for their provider network, allowing doctors to focus on patient care while the central team manages revenue cycle, scheduling, and compliance. The organization is actively expanding its managed practice portfolio and needs sharp, reliable remote talent to scale alongside that growth.

Job description

You will serve as a critical link between insurance payers and a multi-practice healthcare network, owning the end-to-end eligibility verification and prior authorization process across several doctor's offices simultaneously. You will work across multiple EHR platforms, coordinate directly with providers and payers, and take proactive ownership of resolving denials and discrepancies — ensuring the revenue cycle stays clean and compliant. This is a high-trust, full-time role where your accuracy and initiative have a direct impact on patient care continuity and the financial health of the practices you support.

Responsibilities

• Verify patient insurance eligibility across multiple practices and payer systems
• Obtain and manage prior authorizations to ensure timely approval of medical services
• Coordinate with providers and insurance companies to resolve authorization denials or discrepancies
• Support revenue cycle integrity by ensuring accurate eligibility data entry and documentation
• Process and track authorization requests across multiple EHR platforms for different practice entities

Must-have requirements

• Proven experience in insurance eligibility verification and prior authorization in a healthcare setting
• Familiarity with working across multiple EHR/EMR systems and managing multi-practice workflows
• Strong understanding of healthcare billing terminology and payer requirements
• High level of attention to detail and accuracy in data handling
• Ability to work independently and manage competing priorities
• HIPAA compliance awareness and commitment to patient data confidentiality

Nice-to-have requirements

• Bonus if you have experience handling authorization denials and appeals across commercial and government payers
• It helps if you've supported revenue cycle operations for primary care or multi-specialty practices
• Bonus if you're comfortable onboarding quickly to new practice workflows as the organization expands

Why join this team

• 100% remote, full-time position with a stable, long-term engagement
• Work with a well-structured healthcare management services team that values accuracy and proactive problem-solving
• Exposure to a growing, multi-practice network — your skills will matter across multiple doctor's offices simultaneously
• Clear growth opportunity as the organization continues to onboard new practices into its managed group
• Collaborative environment with internal teams focused on revenue cycle integrity and patient outcomes

Apply now. Start helping.