Prior Authorization Administrative Specialist

Applicant Data Privacy And Protection Notice

Opportunities at Change Healthcare, part of the Optum family of businesses. We are transforming the health care system through innovative technology and analytics. Find opportunities to make a difference in a variety of career areas as we all play a role in accelerating health care transformation. Help us deliver cutting-edge solutions for patients, hospitals and insurance companies, resulting in healthier communities. Use your talents to improve the health outcomes of millions of people and discover the meaning behind: Caring. Connecting. Growing together.

Work Location:
Augusta, Maine

Overview of Position
The Medical Prior Authorization Administrative Specialist is responsible for: Using the various electronic systems to receive, review, and research requests from community providers for prior authorization of medical supplies and services as well as dental services. This position requires a relatively high degree of independent action and initiative. The person in this position must demonstrate good time management skills, maintain a positive teamwork environment, and be detail oriented.

What will be my duties and responsibilities in this job?

• Works closely side by side with nurses to process prior authorization requests
• Develops a working knowledge of Maine Medicaid Prior Authorization Medical Policy
• Develops a working knowledge of contractual performance requirements
• Triage of the Medical Prior Authorization work queues
• Process PAs within the scope of an administrative specialist, adhering to contractual timelines
• Receive provider and client telephone calls
• Assists in creating/updating the internal Admin DLP process

What are the requirements needed for this position?

• High School diploma or GED required

• 1-2 years’ experience with data entry essential
• Minimum of intermediate knowledge of Microsoft Office Suite

What other skills/experience would be helpful to have?

• Previous experience in health care or insurance helpful, previous administrative and/or supportive role

• Some college preferred

What are the working conditions and physical requirements of this job?

• Environment – office
• Physical Requirements – Sitting, standing, walking, and using keyboard.
• This position became remote due to COVID. While it is not a 100% remote position, there will be some flexibility within office work on an as needed basis. At this time all staff remain remote with occasional office duties. Candidate must be commutable distance to the office.

Unique Benefits*:
• Flexible work environments
• Ready, Set, Grow Career Development Center & access to Change Healthcare University for continuous professional learning & development with more than 5,000 training assets
• Volunteer days, employee giving and matching gifts programs, community awards and dollars for doers, community partnerships
• Employee wellbeing programs and generous health plans
• Educational assistance programs
• US 401(k) or Group RRSP (Canada) savings plans with matching employer contributions
• Be sure to ask our Talent Advisors for more information on location specific benefits and paid time off policies
• Learn more at https://careers.changehealthcare.com
*Eligibility for some benefits may be limited or not available for part-time employees, be sure to speak with your Talent Advisor.

Diversity, Equity & Inclusion:

•At Change Healthcare, we include all. We celebrate diversity and inclusivity, respect each other and value our unique experiences. By being our authentic selves, we bring different perspectives into our work and relationships.
•Business Resource Groups (BRGs) play a central role in advancing diversity and inclusion at Change Healthcare. They deepen our understanding of different cultures, people, and experiences, and help foster an inclusive workplace. Change offers eight (8) BRGs. Learn more at https://careers.changehealthcare.com/diversity

Feeling Inspired? Ready to #MakeAChange? Apply today!

COVID Vaccination Requirements

We remain committed to doing our part to ensure the health, safety and well-being of our team members and our communities. As such, some individuals may be required to disclose COVID-19 vaccination status prior to or during employment. Certain roles may require COVID-19 vaccination and/or testing as a condition of employment. Change Healthcare adheres to COVID-19 vaccination regulations as well as all client COVID-19 vaccination requirements and will obtain the necessary information from candidates prior to employment to ensure compliance.

Equal Opportunity/Affirmative Action Statement

Change Healthcare is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, age, sex, sexual orientation, gender identity, genetic information,  national origin, disability, or veteran status. To read more about employment discrimination protections under federal law, read EEO is the Law at https://www.eeoc.gov/employers/eeo-law-poster and the supplemental information at https://www.dol.gov/ofccp/regs/compliance/posters/pdf/OFCCP_EEO_Supplement_Final_JRF_QA_508c.pdf.

If you need a reasonable accommodation to assist with your application for employment, please contact us by sending an email to

Click here https://www.dol.gov/ofccp/pdf/pay-transp_%20English_formattedESQA508c.pdf to view our pay transparency nondiscrimination policy.

California (US) Residents: By submitting an application to Change Healthcare for consideration of any employment opportunity, you acknowledge that you have read and understood Change Healthcare’s Privacy Notice to California Job Applicants Regarding the Collection of Personal Information.

Change Healthcare maintains a drug free workplace and conducts pre-employment drug-testing, where applicable, in accordance with federal, state and local laws.

Applicant Data Privacy And Protection Notice