RCM Authorization Specialist

We are seeking an experienced RCM Authorization Specialist to join a growing Revenue Cycle Management team. This role is responsible for obtaining and verifying prior authorizations for diagnostic testing, ensuring services are approved accurately and on time to support reimbursement, reduce denials, and create a seamless patient experience.

The ideal candidate will have a strong background in healthcare revenue cycle operations, insurance verification, and prior authorizations. Success in this role requires exceptional attention to detail, strong communication skills, and the ability to manage multiple priorities in a fast-paced environment.

Key Responsibilities

• Obtain and verify prior authorizations for diagnostic testing.
• Review patient records and scheduled services to determine authorization requirements.
• Communicate with physician offices, insurance carriers, and patients to facilitate timely authorization approvals.
• Track and monitor pending authorizations to ensure completion prior to scheduled service dates.
• Investigate and resolve authorization-related denials, partnering with billing and coding teams as needed.
• Stay current on payer policies, benefit changes, authorization requirements, and reimbursement guidelines.
• Support audits, compliance reviews, and reporting initiatives within the Revenue Cycle Management department.
• Maintain accurate documentation and ensure compliance with HIPAA and organizational policies.
• Identify opportunities to improve authorization workflows and reduce reimbursement delays.

Qualifications:

• Bachelor's degree preferred or equivalent combination of education and relevant experience.
• Minimum of 5 years of experience in medical billing, prior authorizations, financial clearance, revenue cycle management, or a related healthcare role.
• Strong understanding of insurance policies, authorization processes, medical billing procedures, and claim terminology.
• Working knowledge of HIPAA requirements and protected health information (PHI) guidelines.
• Excellent interpersonal, verbal, and written communication skills.
• Strong analytical, organizational, and problem-solving abilities.
• Ability to work independently while managing a high-volume workload with accuracy.

Preferred Experience

• Prior experience supporting diagnostic or laboratory testing authorizations.
• Experience using laboratory billing platforms such as Telcor, Xifin, or Quadax.
• Background working with complex insurance plans, payer portals, and denial resolution

Compensation

About Us

Robert Half is the world’s first and largest specialized talent solutions firm that connects highly qualified job seekers to opportunities at great companies. We offer contract, temporary and permanent placement solutions for finance and accounting, technology, marketing and creative, legal, and administrative and customer support roles.

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All applicants applying for U.S. job openings must be legally authorized to work in the United States. Benefits are available to contract/temporary professionals, including medical, vision, dental, and life and disability insurance. Hired contract/temporary professionals are also eligible to enroll in our company 401(k) plan. Visit roberthalf.gobenefits.net for more information.

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