Insurance Verification Specialist

TAJ Technologies, Inc. (client of TTI) is hiring a Prior Authorization Specialist to support patient access to therapies by verifying prior authorization requirements and obtaining approvals. The role works closely with physician offices and payers to confirm coverage, submit authorization requests, and assist with appeals when needed.

• Validate patient insurance coverage and benefits and communicate coverage issues to appropriate managers

• Determine prior authorization requirements and initiate authorization requests as needed

• Coordinate and submit required paperwork, clinical notes, and forms to support authorization requests

• Follow up regularly with payers and stakeholders to track authorization status through approval

• Assist with appeals for prior authorization denials and handle retro-authorization or special cases

• Work directly with physician offices, payer representatives, utilization reviewers, and internal stakeholders to facilitate patient access

• Knowledge of payer payment processes and strong understanding of payer prior authorization workflows

• Familiarity with ICD-9/10 and CPT codes; expert knowledge of a subset of Medtronic therapy codes

• Superior customer service and strong communication skills with multiple stakeholder types

• Advanced Microsoft Excel skills

• Ability to learn and use multiple CRM software programs

• Strong organizational skills, ability to manage multiple inquiries, critical problem-solving, and high attention to detail

• Location: Remote

• Duration: 24 months or longer with possible extensions