The Pre‑Authorization Specialist is responsible for obtaining timely and accurate prior authorizations for medical services, procedures, and medications. The role ensures compliance with payer guidelines, reduces claim denials, and supports the overall efficiency of the Revenue Cycle Management (RCM) process. Key Responsibilities 1. Prior Authorization & Verification Review physician orders and clinical documentation to determine authorization requirements. Contact insurance providers to obtain prior authorizations for procedures, imaging, surgeries, and medications. Verify patient eligibility, benefits, coverage limitations, and out‑of‑pocket responsibilities. Ensure authorizations are documented accurately in the system before the date of service. 2. Communication & Coordination Communicate authorization status to providers, scheduling teams, and patients. Coordinate with clinical staff to obtain additional medical records needed for authorization approval. Follow up with...