Raventra Health is a medical services company providing outsourced billing, coding, and claims processing solutions for provider groups and hospitals. As a Prior Authorization Specialist, you will coordinate prior authorization requests for scheduled procedures, treatments, and services on behalf of provider clients. You will work with payer portals, provider teams, and clinical documentation to help secure timely approvals and resolve authorization-related issues.
WHAT YOU WILL DOSubmit and track prior authorization requests across multiple insurance payers
Gather and review clinical documentation required to support authorization requests
Communicate with provider teams to obtain missing information or documentation
Follow up with payers on pending requests and monitor authorization status through resolution
Identify authorization issues and pursue reconsiderations or appeals when requests are denied
Maintain accurate records of authorization requests, decisions, and follow-up actions
Stay current on payer-specific authorization requirements and communicate relevant changes to the team
Escalate delays, complex cases, and potential barriers to timely patient care when appropriate
2+ years of experience in prior authorization, insurance verification, medical billing, or a related healthcare role
Experience working with insurance payer portals and authorization requirements
Ability to understand and interpret clinical documentation
Strong attention to detail and ability to manage multiple authorization requests simultaneously
Persistence and strong follow-through when working through multi-step authorization or appeal processes
Strong written and verbal communication skills when working with providers, payers, and internal teams
Ability to work independently while meeting productivity and turnaround expectations
HIPAA-compliant private workspace and ability to work effectively in a fully remote role
Experience with specialty-specific prior authorizations
Pharmacy prior authorization experience
Clinical or healthcare background
Experience with an EMR system such as Epic, Athena, or eClinicalWorks
Experience handling authorization denials, reconsiderations, or appeals
Compensation will be discussed during the interview and will reflect the candidate’s experience, qualifications, and relevant healthcare revenue cycle expertise.
Benefits and additional employment details will be discussed during the hiring process.
HIRING PROCESSApplication review → introductory conversation → hiring manager interview → offer.
EQUAL OPPORTUNITYRaventra Health is an equal opportunity employer. We consider all qualified applicants without regard to race, colour, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or any other protected characteristic. If you need an accommodation at any stage of the hiring process, please contact us and we will work with you to provide appropriate support.
Location: Remote
Skills Required
- 2+ years of experience in prior authorization, insurance verification, medical billing, or related healthcare role
- Experience working with insurance payer portals and authorization requirements
- Ability to understand and interpret clinical documentation
- Strong attention to detail and ability to manage multiple authorization requests simultaneously
- Persistence and strong follow-through on multi-step authorization and appeal processes
- Strong written and verbal communication skills with providers, payers, and internal teams
- Ability to work independently while meeting productivity and turnaround expectations
- HIPAA-compliant private workspace and ability to work effectively in a fully remote role
- Experience with specialty-specific prior authorizations
- Pharmacy prior authorization experience
- Clinical or healthcare background
- Experience with an EMR system such as Epic, Athena, or eClinicalWorks
- Experience handling authorization denials, reconsiderations, or appeals
What We Do
CareerSwift is an AI-powered recruitment and job search automation platform designed for both professionals and growing companies. It streamlines the hiring process through AI-driven resume optimization, intelligent job discovery, and automated candidate screening and interviewing. By utilizing context-aware AI agents, CareerSwift helps job seekers land roles faster and enables companies to identify high-quality talent more efficiently.
