Healthcare Authorization Support Specialist

Seeking a detail-oriented Healthcare Authorization Support Specialist to process Medicare and health insurance requests, verify member eligibility and benefits, and support authorization and pre-certification workflows. This role involves handling incoming requests, reviewing documentation, and coordinating with nursing teams to ensure timely and accurate processing.

Key Responsibilities

• Process requests, inquiries, and transactions received by phone, email, fax, and mail.


• Review requests and supporting documentation for accuracy and completeness.


• Verify member eligibility, benefits, provider information, and authorization requirements.


• Enter and maintain service requests, research missing or incorrect information, and route unresolved issues to the appropriate team.


• Triage and assign incoming inquiries efficiently to ensure timely follow-up.


• Document interactions and provide verbal or written authorization outcome notifications to members and providers.


• Analyze inquiry trends and share feedback with team leads regarding training needs and provider education.


• Conduct monthly peer audits as required.

Required Qualifications

• High school diploma or GED.


• At least 3 years of relevant healthcare, health insurance, or related experience.


• Medicare experience.


• Familiarity with health insurance processes and Microsoft Office applications.


• Strong attention to detail, organizational skills, and communication abilities.

Preferred Qualifications

• Experience with triage, referral processing, or authorization support.


• Pharmaceutical knowledge or experience.


• Experience working with prior authorization or pre-certification processes.

Training

• Training includes approximately two weeks of classroom instruction, followed by two to three weeks of job shadowing and hands-on training. The goal is to become comfortable managing daily responsibilities by the end of the fourth week.

Consulting Solutions and its family of companies is an equal opportunity employer, and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity or expression, pregnancy, age, national origin, disability status, genetic information, protected veteran status, or any other characteristic protected by law. If you are a person with a disability needing assistance with the application or at any point in the hiring process, please contact us at: requests@consultingsolutions.com