Prior Authorization Specialist / Referral Navigator Representative

Pride Health is hiring a Remote Prior Authorization Specialist / Referral Navigator Representative to support our client’s. This is a 3+ month contract assignment (Possibility of conversion or extension) and a great way to start working with a top-tier healthcare organization!

Job Details:

• Location: Fully remote
• Job Type: 3+ months (Possibility of extension or conversion )
• Schedule: - Monday-Friday 8 am – 7pm
• Pay Range: $12-$13/hr. on W2

Position background - Fax coordination for the Authorization Navigator Position.

The ideal candidate has a background in healthcare administration, prior authorization processing, or health plan operations. Experience working with insurance plans, managed care, or provider offices handling referrals and authorizations is highly preferred. Familiarity with utilization management workflows and payer requirements is important.

Specific Duties:

• 2–4+ years of experience in prior authorization processing, referrals, or healthcare operations Insurance Knowledge: Understanding of payer guidelines, authorization requirements, and basic medical terminology
• Documentation Skills: Strong attention to detail with accurate and thorough documentation
• Communication Skills: Ability to clearly communicate with providers, clinics, and internal teams
• Time Management: Ability to manage high-volume workloads and meet turnaround time requirements
• Critical Thinking: Ability to review requests and identify missing or required information
• Technical Skills: Experience with EMR systems, authorization platforms, and Microsoft Office tools

Requirements:

• Familiarity with compliance standards and audit processes
• Experience with workflow improvements or training support
• Strong organizational skills with the ability to prioritize competing tasks
• Experience in a fast-paced, high-volume environment with a focus on accuracy and quality

Pride-Health offers eligible employee’s comprehensive healthcare coverage (medical, dental, and vision plans), supplemental coverage (accident insurance, critical illness insurance and hospital indemnity), 401(k)-retirement savings, life & disability insurance, an employee assistance program, legal support, auto, home insurance, pet insurance and employee discounts with preferred vendors.

Equal Employment OpportunityPride-Health is an equal opportunity employer. We do not discriminate on the basis of the race, religious creed, color, national origin, ancestry, physical disability, mental disability, reproductive health decision making, medical condition, genetic information, marital status, sex, gender, gender identity, gender expression, age, sexual orientation, veteran or military status, or any other characteristic protected by applicable federal, state, or local law.

Fair Chance EmploymentPride-Health is a Fair Chance employer. We consider all qualified applicants, including those with criminal histories, in a manner consistent with applicable state and local Fair Chance laws and ordinances, including, the California Fair Chance Act and all applicable local Fair Chance ordinances.

AccommodationsWe are committed to providing reasonable accommodations to applicants and employees with disabilities. If you require a reasonable accommodation to participate in the application or interview process, or to perform the essential functions of this role, please contact us.

Only applicable for San Francisco Candidates: Under the San Francisco Lactation in the Workplace Ordinance, we will provide written notice of lactation accommodation rights, and this notice will automatically be given upon hiring, any inquiry of parental leave or lactation accommodation.

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