Role Description
Labcorp is seeking a Remote Prior Authorization Specialist I to join our team!
Work Schedule: Monday - Friday 8:00 AM - 5:00 PM EST
• Well-versed in pre-authorization processes and policies to respond clearly to high-volume billing tasks and inquiries.
• Maintain appropriate response time in various communication platforms (Example: phone calls, chats, emails, portal inquiries, etc).
• Identify issues and suggest potential improvements.
• Collaborate with your team and develop best practices to ensure we are providing the best service and experience to all customers.
• Maintain an assigned schedule, and be flexible with daily schedules when business needs change.
• Examine incoming orders to ensure completeness and accuracy of required documentation for prior authorization.
• Work directly with various vendors to ensure successful submissions of prior authorizations.
• Monitor the status of prior authorization requests, follow up on pending cases, and initiate follow-ups, if necessary, to ensure timely approvals.
• Stay informed about insurance policies and guidelines, ensuring that all prior authorization requests align with the necessary criteria.
• Maintain accurate records of prior authorization requests, approvals, and denials. Enter relevant information into databases.
• Participate in projects that extend beyond your day-to-day to stretch you to think outside the box.
Qualifications
• High school diploma or GED or equivalent.
• 1 year or more years insurance claims or pre-authorization or medical benefits work experience.
Requirements
• Associate’s degree (preferred).
• 1 year or more clinical laboratory Revenue Cycle Management (RCM) experience (preferred).
• Ability to work remotely from a private, quiet workspace.
• Reliable high‑speed internet connection (minimum 50 Mbps).
• Proficiency with Microsoft Office (Word, Excel, Outlook).
• Strong customer service, time management, and organizational skills.
• Excellent verbal and written communication abilities.
• High attention to detail with the ability to manage multiple priorities.
• Solid understanding of medical terminology, insurance guidelines, and healthcare regulations.
• Self‑motivated, collaborative, and willing to take initiative to get work done.
• Strong work ethic with flexibility and a commitment to supporting positive patient outcomes.
• Enjoys problem‑solving in a fast‑paced, team‑oriented, and evolving environment.
• Provide responsive, professional support to providers, patients, and insurance representatives regarding prior authorization status and requirements.
Benefits
• Comprehensive benefits including: Medical, Dental, Vision, Life, STD/LTD, 401(k), Paid Time Off (PTO) or Flexible Time Off (FTO), Tuition Reimbursement and Employee Stock Purchase Plan for employees regularly scheduled to work 20 or more hours per week.
• Employees regularly scheduled to work less than 20 hours, Casual, Intern, and Temporary employees are only eligible to participate in the 401(k) Plan.
• Employees who are regularly scheduled to work a 7 on/7 off schedule are eligible to receive all the foregoing benefits except PTO or FTO.