Prior Authorization Specialist

Role: Prior Authorization Specialist responsible for obtaining insurance approvals for Adaptive’s clonoSEQ MRD assay, ensuring timely patient access and compliance with payer requirements. Responsibilities include managing authorization requests, reviewing clinical documentation, resolving issues with insurance companies, maintaining accurate records, and collaborating with billing teams to optimize workflow. Requirements: high school diploma, 2+ years in prior authorization, medical billing, or insurance verification; strong understanding of insurance processes, medical terminology, and proficiency in EMR and Microsoft Office. Preferred qualifications include an associate or bachelor’s degree, experience with Careviso, Glidian, Quadax systems, and familiarity with molecular or genetic testing. High-value specifics: role supports genetic testing assays, operates in a laboratory setting, involves regulatory compliance with HIPAA, and requires flexibility for working non-standard hours. Work setup: primarily desk-based with potential evening/weekend shifts; physical requirements involve mainly sedentary work.