Prior Authorization Specialist, Medellín
On-site - Full-Time

We are a growing healthcare organization focused on delivering high-quality, patient-centered care through efficient, compliant, and financially sustainable clinical operations. Our teams support specialty practices, including pain management, and rely on timely and accurate prior authorizations to ensure patients receive approved care without unnecessary delays or financial risk. As we continue to expand, we are seeking dedicated professionals who thrive in payer-driven environments and take ownership of authorization workflows.

We are currently seeking a Prior Authorization Specialist to manage insurance authorization processes for procedures, treatments, and medications. This role is critical in bridging clinical documentation with payer medical policies to secure approvals, prevent denials, and support seamless patient care.

Position Summary

As a Prior Authorization Specialist, you will serve as a key liaison between healthcare providers, insurance companies, and patients.



Your primary responsibility is to ensure that proposed medical services meet payer medical necessity criteria and are authorized in a timely manner. This role requires strong attention to detail, knowledge of CPT and ICD-10 coding, and persistence in navigating payer portals, follow-ups, and appeals to protect both patients and the organization from unnecessary financial exposure.

What You’ll DoAuthorization & Payer Management
- Review clinical documentation to determine medical necessity and payer guideline compliance.
- Submit prior authorization requests through payer portals, fax, or phone.
- Prioritize incoming authorization requests based on urgency and scheduled services.
- Track, monitor, and follow up on pending authorizations to ensure timely resolution.
- Initiate and manage appeals for denied authorizations, submitting supporting documentation and additional information as required.
- Maintain payer-specific authoriz

📌 Prior Authorizations Specialist (Medellín)
🏢 RVStaffing
📍 Medellín