Prior Authorization Specialist (Care Coordination Representative)
Posted:
Position: Prior Authorization Specialist (Care Coordination Representative)
Date Posted: June 25, 2026
Industry: Healthcare / Health Information Management / Insurance Services
Employment Type: Full Time
Experience: Experience with DME & Diagnostic Testing Prior Authorizations Preferred
Qualification: High School Diploma or Equivalent (Healthcare or HIM Experience Preferred)
Salary: 15.25 USD to 17.50 USD/Hr
Location: United States (Remote / Hybrid / Onsite Options)
Company: Verisma
Description:
Verisma is seeking a detail-oriented Prior Authorization Specialist to join its Care Coordination team. This role focuses on supporting healthcare operations by managing prior authorizations, insurance verification, and health information management tasks to ensure timely and accurate patient care coordination.
The position involves working within electronic health record (EHR) systems to process medical documentation, manage referrals, and complete administrative healthcare tasks. Accuracy, efficiency, and compliance with HIPAA and client protocols are critical to success in this role.
This is an excellent opportunity for individuals who thrive in fast-paced healthcare environments and are passionate about improving operational efficiency in patient care services.
Key Responsibilities:
• Process care coordination and prior authorization tasks with accuracy and efficiency
• Review medical documents and file them into electronic patient records
• Perform insurance verification and referral management
• Navigate multiple EHR systems and internal platforms
• Handle high-volume data entry with strong attention to detail
• Maintain compliance with HIPAA and client-specific protocols
• Track work performance and ensure service level standards are met
• Communicate issues, delays, or discrepancies to supervisors
• Participate in training, meetings, and cross-functional support tasks
Requirements:
• High School Diploma or equivalent required
• Experience with healthcare, HIM, or medical terminology preferred
• Prior experience with DME or diagnostic prior authorizations is a plus
• Strong attention to detail and ability to manage high workloads
• Intermediate computer skills (Microsoft Office and healthcare systems)
• Ability to work across multiple applications simultaneously
• Strong knowledge of:
• Health Information Management (HIM) practices
• Electronic Health Records (EHR) systems
• Insurance verification and authorization processes
• HIPAA compliance and healthcare data privacy standards
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