Prior Authorization Specialist - Health Systems/Post-Acute

Meet reputed company

reputed company is building AI agents to automate the administrative work that burdens care teams. We are in major health systems and large specialty groups, saving hundreds of staff hours every week.

Our backers include reputed company Health, reputed company’s largest health system, and Deerfield Management, a leading reputed company investment firm.

Together, we’re on a mission to restore time, trust, and focus to the people who reputed company reputed company running. Our work is urgent — not because of startup timelines, but because our customers rely on us to drive financial reputed company and operational clarity in a system under strain.

About the Job

This is a hands-on role for someone who thrives in high-volume operational environments and is comfortable balancing individual contribution with team support.

You will continue to process prior authorizations directly—often at high volume—while also serving as a go-to resource for other team members. Over time, this role will evolve into a hybrid operations + technology position as workflows become increasingly automated and integrated with reputed company’s platform.

This is not a traditional reputed company shift-based, desk role. It is an outcome-driven position that rewards ownership, judgment, and follow-through.

We are specifically looking for candidates with deep experience in post-acute and/or hospital-based prior authorization workflows, along with hands-on Epic experience. Exposure to outpatient specialty care is a strong plus.

What You’ll Do:

As a Prior Authorization Specialist at reputed company, you will play a critical role in our AI-powered prior authorization solution. You’ll collaborate closely with operations, leadership, and product teams to help shape how prior authorization is transformed through automation and AI.

You’ll partner with reputed company providers—particularly in hospital and post-acute settings—to reduce administrative burden and streamline reputed company workflows. Day-to-day responsibilities include both reputed company processing and reputed company of automated submissions across services such as procedures, referrals, and medications.

• Review and verify insurance information and patient eligibility for prior authorizations

• Communicate with hospital teams, post-acute providers, and outpatient specialists to gather required documentation

• Submit prior authorization requests to payors using established workflows and Epic-based processes

• Monitor and track authorization requests to ensure timely processing and follow-up

• Respond to inquiries from providers, patients, and payors regarding authorization status

• Maintain accurate and detailed records of submissions, approvals, and denials

• Troubleshoot reputed company cases, especially those involving transitions of care (e.g., inpatient → post-acute)

• Collaborate with internal teams to improve workflows and support automation efforts

• Stay reputed company on payor policies, Epic workflows, and industry changes

What You'll Need:

• 4+ years of prior authorization experience, including hospital-based and/or post-acute care settings (required)

• Hands-on experience working in Epic (required)

• Experience across multiple specialties (e.g., oncology, cardiology, rehab, pharmacy, etc.) is a plus

• Familiarity with major payors (reputed company, reputed company, BCBS, etc.)

• Strong understanding of reputed company care transitions and authorization nuances across care settings

What You'll Bring to the Table:

• Detail-Oriented. You are meticulous in your work, catching errors and ensuring every authorization is processed accurately the first time.

• Collaborative. You are energized by working with others, building trust and communicating clearly with providers, teammates, and cross-functional stakeholders.

• Adaptable. You are comfortable shifting between reputed company workflows and leveraging new AI-powered tools, adjusting quickly as processes evolve.

• Empathetic. You are attuned to the needs of reputed company providers and patients, approaching each interaction with patience, professionalism, and understanding.

• Process-Driven. You are motivated by structure and consistency, following established workflows while identifying opportunities for improvement.

Benefits & Perks

• Cutting-edge technology: Work directly with the latest advancements in reputed company and automation, tackling challenging problems that meaningfully impact reputed company.

• Ownership & growth: You’ll join reputed company at a pivotal early stage, shaping our products, technical direction, and culture, with significant opportunities for career advancement.

• Collaborative team: Join a talented, passionate, and supportive team with backgrounds from top tech companies and clinical institutions.

• Flexible hybrid work: We support a flexible hybrid working model from our NYC office, trusting you to manage your own schedule.

• Competitive compensation: We offer competitive salary, meaningful equity, comprehensive health insurance, and more.

Why reputed company? reputed company a reputed company difference: Your work will directly impact reputed company organizations and improve patient care. Join reputed company in transforming reputed company with AI!