New

Prior Authorization Specialist - Gastroenterology

Vaco
$22.00 - $24.00 / hr
United States, Kentucky, Louisville
Jan 31, 2026
Job Summary We are seeking a detail-oriented Prior Authorization Specialist with gastroenterology experience to support our clinical and revenue cycle teams. This role is responsible for obtaining timely insurance authorizations for GI-related procedures, imaging, medications, and treatments to ensure uninterrupted patient care and accurate reimbursement. Key Responsibilities Obtain prior authorizations for gastroenterology procedures, including endoscopies, colonoscopies, biologics, imaging, and specialty medications Review provider orders and clinical documentation to ensure medical necessity and payer compliance Submit authorization requests through payer portals, phone, and fax Track authorization status and follow up with insurance companies to ensure timely approvals Communicate authorization outcomes, denials, and requirements to providers, clinical staff, and patients Coordinate peer-to-peer reviews and appeals as needed Maintain accurate documentation in the EHR and authorization tracking systems Stay up to date on payer guidelines, GI-specific policies, and insurance requirements Work closely with scheduling and billing teams to prevent delays or claim denials Qualifications High school diploma or equivalent required; associate or bachelor's degree preferred 1+ years of prior authorization experience, preferably in gastroenterology or a specialty practice Strong knowledge of insurance plans, CPT/ICD-10 codes, and medical necessity requirements Experience with biologics and specialty medications (preferred) Familiarity with EHR systems and payer portals Strong attention to detail and ability to manage multiple authorizations simultaneously Excellent communication and follow-up skills Preferred Skills Experience with GI procedures and terminology Knowledge of Medicare, Medicaid, and commercial insurance plans Appeals and denial management experience Ability to work independently in a fast-paced clinical environment Vaco by Highspring values a diverse workplace and strongly encourages women, people of color, LGBTQ+ individuals, people with disabilities, members of ethnic minorities, foreign-born residents, and veterans to apply. EEO Notice Vaco by Highspring is an Equal Opportunity Employer and does not discriminate against any employee or applicant for employment because of race (including but not limited to traits historically associated with race such as hair texture and hair style), color, sex (includes pregnancy or related conditions), religion or creed, national origin, citizenship, age, disability, status as a veteran, union membership, ethnicity, gender, gender identity, gender expression, sexual orientation, marital status, political affiliation, or any other protected characteristics as required by federal, state or local law. Vaco by Highspring and its parents, affiliates, and subsidiaries are committed to the full inclusion of all qualified individuals. As part of this commitment, Vaco by Highspring and its parents, affiliates, and subsidiaries will ensure that persons with disabilities are provided reasonable accommodations. If reasonable accommodation is needed to participate in the job application or interview process, to perform essential job functions, and/or to receive other benefits and privileges of employment, please contact HR@vaco.com . Vaco by Highspring also wants all applicants to know their rights that workplace discrimination is illegal. By submitting to this position, you agree that you will be giving Vaco by Highspring the exclusive right to present your as a candidate for the foregoing employment opportunity. You further agree that you have represented information about yourself accurately and have not affirmatively misrepresented your qualifications. You also agree to maintain as confidential, to the fullest extent permitted by law, any information you learn from Vaco by Highspring about the position and you will limit disclosure of information about the position only to the extent necessary to perform any obligations in furtherance of your application. In exchange, Vaco by Highspring agrees to exercise reasonable efforts to represent you through all solicitation, job screening and resume dispersal. Privacy Notice Vaco by Highspring and its parents, affiliates, and subsidiaries ("we," "our," or "Vaco by Highspring") respects your privacy and are committed to providing transparent notice of our policies. California residents may access Vaco by Highspring HR Notice at Collection for California Applicants and Employees here. Virginia residents may access our state specific policies here. Residents of all other states may access our policies here. Canadian residents may access our policies in English here and in French here. Residents of countries governed by GDPR may access our policies here. Pay Transparency Notice Determining compensation for this role (and others) at Vaco by Highspring depends upon a wide array of factors including but not limited to: the individual's skill sets, experience and training; licensure and certification requirements; office location and other geographic considerations; other business and organizational needs. With that said, as required by local law, Vaco by Highspring believes that the following salary range referenced above reasonably estimates the base compensation for an individual hired into this position in geographies that require salary range disclosure. The individual may also be eligible for discretionary bonuses.