Prior Authorization Specialist

Summary

Join Synapticure as a Prior Authorization Specialist and collaborate with care teams, patients, and insurance providers to ensure timely access to medications and services. You will submit prior authorization requests, gather necessary documentation, communicate with insurance representatives, and keep accurate records. This role requires 2+ years of experience in prior authorizations within a healthcare setting, strong communication skills, and a passion for patient advocacy. Synapticure offers a remote-first work environment with competitive compensation, benefits including medical, dental, vision, life insurance, disability, 401k matching, and generous paid time off. The company is committed to patient-centric care and offers opportunities for career growth.

Requirements

• 2+ years of experience in prior authorizations, insurance coordination, or case management in a healthcare setting; preferred experience in neurology, radiology or infusion settings
• Understanding of healthcare insurance systems, especially for complex, long-term treatments
• Strong communication skills with the ability to explain complex medical and insurance information in an empathetic, patient-friendly manner
• Passion for patient advocacy with a problem-solving mindset, focusing on overcoming challenges to accessing care
• Ability to work effectively both independently and as part of a multidisciplinary team, including neurologists, health systems, independent providers, and insurers

Responsibilities

• Collaborate with insurers to obtain pre-authorizations for condition-specific medications, diagnostic procedures and treatments, and support patients in navigating barriers / coverage and disputes
• Submit prior authorization requests for medical procedures, diagnostic tests, treatments, and medications as required by insurance providers
• Gather, review, and submit all necessary clinical documentation to support authorization requests, ensuring accuracy and completeness
• Communicate with insurance representatives to clarify requirements, resolve authorization denials, and follow up on pending approvals
• Collaborate with physicians, nurses, and other clinical staff to obtain additional clinical information or documentation required by insurance companies
• Inform patients about the status of their authorization requests, answer questions regarding coverage, and provide guidance on next steps
• Maintain accurate and detailed records of all prior authorization requests, outcomes, and patient information in compliance with HIPAA regulations
• Stay updated on changes in insurance policies, state and federal regulations, and organizational policies affecting prior authorizations and reimbursement

Preferred Qualifications

Preferred clinical experience and understanding of medical terminology

Benefits

• Remote-first design with work from home stipend
• Competitive compensation with an annual bonus opportunity
• 401(k) with matching contribution from day 1
• Medical, Dental and Vision coverage for you and your family
• Life insurance and Disability
• Generous sick leave and paid time off
• Fast growth company with opportunities to progress in your career