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Prior Authorization Specialist

New York

About us:

Here at Trovo Health, we’re on a mission to help solve healthcare’s clinical capacity crisis. By combining AI-powered technology with a proprietary network of ancillary clinicians, we allow our partners to access transformative clinical capabilities.

We’ve raised funding led by Oak HC/FT - backers of leading clinical technology companies such as Devoted Health, VillageMD, CareBridge, Main Street health, Maven Clinic, and more.

We’re headquartered in NYC, and embrace a hybrid work culture.

About the Role:

As a Prior Authorization Specialist at Trovo, you will be instrumental in enhancing the patient experience by securing essential insurance approvals for healthcare services using AI-enhanced workflows. You’ll collaborate with clinical teams and external partners to ensure efficient, compliant processing of prior authorization requests. This role requires expertise in healthcare authorization processes (medical and prescription) and proactive communication skills. This is an hourly role set at 40 hours a week.

The Following Should Describe You:

  • You are passionate about helping patients access timely, quality healthcare.

  • You bring a high level of detail orientation and consistency to managing healthcare documentation and insurance requests.

  • You’re driven to solve problems and improve processes in a dynamic healthcare environment.

  • You thrive on collaborating with both internal teams and external partners to drive outcomes.

  • You’re excited to work with new technology to improve workflows and patient experience

Responsibilities:

  • Coordinate and manage prior authorization requests to ensure patients receive timely approvals for needed treatments and procedures.

  • Act as a liaison between providers, patients, and insurance companies to clarify requirements, resolve issues, and facilitate approvals.

  • Work closely with clinical and operational teams to ensure all necessary medical documentation is prepared, complete, and compliant with insurance protocols.

  • Monitor the status of authorization requests, proactively following up on pending cases, and promptly addressing denials or additional information requests.

  • Leverage Trovo Health’s internal tools and technology to streamline authorization workflows and maintain accurate, up-to-date records.

  • Identify patterns and common barriers within the authorization process and suggest improvements to enhance efficiency and reduce delays.

  • Communicate with providers and patients to explain authorization outcomes and next steps in a compassionate, clear manner.

Must Haves:

  • 2+ years of experience in prior authorization, healthcare administration, or a related field within a healthcare setting.

  • Familiarity with healthcare insurance, medical billing, and authorization guidelines, including experience navigating insurance requirements and protocols.

  • Strong communication and problem-solving skills, with a talent for managing multiple tasks and prioritizing effectively.

  • Knowledge of CPT, ICD9, and ICD10 coding

  • Proficiency in using EHRs, prior authorization portals, and other healthcare software.

Nice-to-Haves:

  • Experience in a technology-forward healthcare environment.

  • Knowledge of AI applications in healthcare administration.

Benefits of Working with Us Include:

  • Hybrid and remote friendly work environment

  • Competitive Salary $25/hr-$30/hr based on candidate experience

Trovo Health is an equal opportunity employer. We celebrate diversity and are committed to creating an inclusive environment for all employees. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, gender identity or expression, sexual orientation, national origin, genetics, disability, age, or veteran status.

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