UPMC is hiring a full-time Senior Authorization Specialist to support the Care Management department. This role works Monday through Friday during daylight hours and is eligible to work from home after training, with an on-site rotation approximately every five weeks.
The position focuses on authorization activities across inpatient, outpatient, and emergency department patients, along with denial management and other revenue-related functions. The role requires strong knowledge of authorization workflows, payer requirements, medical necessity review, and denial resolution.
High school diploma or equivalent with 4 years of experience in a medical environment, or an associate degree with 2 years of experience in a medical environment.
Bachelor's degree preferred.
Completion of a medical terminology course or equivalent, or 3 years of experience working in the medical field.
Knowledge and interpretation of medical terminology, ICD, and CPT codes.
Proficiency with Microsoft Office applications.
Excellent communication and interpersonal skills.
Ability to analyze data and use independent judgment.
Preferred experience with authorization processes, insurance regulations, third-party payors, reimbursement practices, and web-based computerized systems.
Work from home after training.
On-site rotation approximately every 5 weeks.
Full-time weekday schedule during daylight hours.
Opportunity to grow within a large health system.
Location
Pittsburgh, Pennsylvania, US
Employment Type
Full-time
Experience Level
Senior
Remote work allowed
Yes
Posted
4 weeks ago