Prior Authorization Specialist

Prior Authorization Specialist

Full Time - Remote

Summary

Innovative Renal Care is seeking a Prior Authorization Specialist to support our dialysis clinics through the timely processing of prior authorizations, referrals, appeals, and authorization renewals.

In this fully remote role, you will work closely with clinic teams, patients, and insurance payers to help ensure required approvals are obtained and maintained for dialysis services. The ideal candidate is organized, detail-oriented, and comfortable managing multiple priorities in a fast-paced environment. Experience in healthcare administration, medical office support, insurance authorizations, referrals, or customer service is a plus.

Responsibilities

• Submit and manage prior authorization, referral, and appeal requests through payer portals, phone, fax, and email.
• Track outstanding authorization requests and follow up with insurance payers to ensure timely resolution.
• Coordinate with clinic staff and patients to obtain documentation needed to support authorization approvals.
• Monitor active authorizations and proactively initiate renewal requests to prevent interruptions in coverage.
• Maintain accurate authorization records, documentation, and reports to support operational and billing processes.
• Serve as a resource for clinics and patients regarding authorization-related questions and payer requirements.
• Maintain HIPAA compliance and protect confidential patient information at all times.

Qualifications

Required

• High School Diploma or equivalent.
• 0-2 years of experience in an administrative, customer service, healthcare support, medical office, or related environment.
• Strong attention to detail and organizational skills.
• Excellent verbal and written communication skills.
• Ability to manage multiple priorities while maintaining accuracy and meeting deadlines.
• Proficiency with Microsoft Office applications.

Preferred

• Experience with prior authorizations, referrals, appeals, healthcare administration, or payer communications.
• Familiarity with Medicare, Medicaid, and commercial insurance processes.
• Experience working in a healthcare setting.
• Bilingual Spanish skills are a plus.

At Innovative Renal Care (IRC), our comprehensive benefits program is a key component of our total compensation package. It includes a 401(k) match, healthcare coverage, and a broad range of other benefits that compare favorably within our industry and marketplace. Learn more atIRC Benefits and Perks.

About Innovative Renal Care

We are one of the largest dialysis service providers in the U.S., partnering with local physicians to deliver high-quality care to patients with ESRD and other kidney conditions. Our mission is to be the trusted experts and preferred partners for patients, physicians, and healthcare providers by delivering best-in-class care, service, and solutions.

Our Values: I CARE

Integrity & Innovation - Earn trust by keeping promises and embracing new solutions.

Compassion - Treat patients, families, and colleagues with respect and empathy.

Accountability - Take ownership and recognize the contributions of others.

Results-Driven - Strive for excellence and exceed expectations.

Everyone Counts - Foster diversity, equity, teamwork, and collaboration.

Why Join IRC?

• Career Growth - Be part of a values-driven team making a meaningful impact.
• Competitive Compensation - Salaries continually benchmarked against market and trends.
• Enhanced PTO - Your most recent dialysis experience counts toward PTO accrual.
• Team Culture - Thrive in a supportive environment that values innovation, accountability, and compassion.

Pay Range: $18.00 - $22.00 / hour depending on experience and qualifications

Innovative Renal Care is an equal opportunity and a drug free workplace.All qualified applicants will receive consideration for employment without regards to race, color, religion, sex, sexual orientation, gender identity, national origins, citizenship, disability or protected veteran status.All applicants will be subject to a drug screening and background check upon acceptance of an offer.

IRC will only contact you from careers@innovativerenal.comor team members with an @innovativerenal.comemail address. Please be cautious and aware of spam or fraudulent emails soliciting personal or banking information. IRC will not request this information via email.

#LI-SW1

#LI-Remote