Prior Authorization Specialist 2

ou health partners

📍 central park ii united states🕐 23d ago🔗 workday

Job Description

**Position Title:** ------------------- Prior Authorization Specialist II **Department:** --------------- Pre-visit Services **Job Description:** -------------------- **General Description** Under general supervision, the Prior Authorization Specialist II effectively manages complex authorizations across multiple payers and specialties.  **Essential Job Duties** _Responsibilities listed in this section are core to the position.  Inability to perform these responsibilities, with or without an accommodation, may result in disqualification from the position._  * Independently manage complex and specialty‑specific authorization requests.  * Interpret payer medical policies and utilization management criteria.  * Resolve authorization denials and incomplete determinations.  * Coordinate with clinical teams to obtain medical necessity documentation.  **General Job Duties** * Performs other duties as assigned **Minimum Requirements** **Education:** High School Diploma or GED required. **Experience:** At least 3 years of prior authorization experience required. **Certification/License/Registration:** CHAA or PACS required after 1 year. **Knowledge, Skills & Abilities** * Applied expertise in payer medical policy interpretation.  * Strong knowledge of specialty‑driven authorization requirements.  * Ability to analyze denial trends and recommend corrective actions.  * Excellent written and verbal communication skills. **Current OU Health Employees - Please click** [HERE](https://wd5.myworkday.com/oumedicine/login.htmld) **to login.** --------------------------------------------------------------------------------------------------------------------- **OU Health is an equal opportunity employer. We offer a comprehensive benefits package, including PTO, 401(k), medical and dental plans, and many more. We know that a total benefits and compensation package, designed to meet your specific needs both inside and outside of the work environment, create peace of mind for you and your family.** ------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
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