The role involves researching payor requirements to aid in insurance verification and prior authorization processes. The specialist will document findings and assist healthcare providers to enable patient access to care.

Investigate and document prior authorization and benefit verification requirements across payors. Research payor portals, submission processes, required documents and policy updates. Validate sources, solve ambiguous problems independently, and communicate findings to cross-functional teams to enable providers to obtain authorizations and verify patient benefits.

Responsible for completing ABA prior authorizations, verifying patient eligibility, and automating processes for healthcare providers. Communicate with insurers and stakeholders effectively.