Prior Authorization Specialist, New York
About us: At Trovo Health, we’re bringing scalable superhuman support to healthcare providers. Our proprietary, clinically-backed AI coordinator acts as an extension of the care team to help enhance the patient experience, improve outcomes, and operate more efficiently. The Trovo Services Team is a network of experienced professionals who use our platform to complete care coordination workflows for our healthcare provider customers. The Trovo Services Team is fully remote. We’re growing rapidly and are backed by Oak HC/FT – investors in leading healthcare and technology companies such as Ambience Healthcare, Devoted Health, VillageMD, CareBridge, Main Street Health, Maven Clinic, and more. About the Role: As a Prior Authorization Specialist on the Trovo Services Team, you will be instrumental in enhancing the patient experience by securing essential insurance approvals for healthcare services using AI-enhanced workflows. You’ll collaborate with clinical teams and external partners to ensure efficient, compliant processing of prior authorization requests. This role requires expertise in healthcare authorization processes (medical and prescription) and proactive communication skills.
Responsibilities
- Coordinate and manage prior authorization requests for imaging, diagnostics, interventions, medications, and procedures.
- Liaise between providers, patients, and insurers to clarify requirements, resolve issues, and drive approval.
- Collaborate with clinical and operational teams to ensure all documentation meets insurance protocols.
- Monitor authorization statuses, proactively following up on pending cases and addressing denials or requests for additional information.
- Utilize Trovo Health’s internal tools and technology to streamline workflows and maintain accurate, up-to-date records.
- Identify and escalate patterns or barriers in the authorization process, suggesting improvements to increase efficiency.
- Communicate outcomes and next steps to providers and patients clearly and compassionately Minimum Qualifications
- 2+ years of experience in prior authorizations, healthcare administration, or a related role in a healthcare provider setting.
- Direct experience supporting providers and other medical staff or managing authorizations, ideally in specialty care (e.g., cardiology, women’s health, gastroenterology, ophthalmology, etc.)
- Solid understanding of healthcare insurance, medical billing, and prior authorization protocols.
- Proficiency in CPT, ICD‑9, and ICD‑10 coding.
- Skilled communication and problem-solving, with the ability to manage multiple tasks and priorities effectively.
- Comfortable working with EHR systems, prior authorization portals, and healthcare software. Strong Additional Qualifications
- Experience in a technology‑forward healthcare setting.
- Knowledge of AI applications in healthcare administration.
- Familiarity with specialty care (e.g., cardiology, urology, gastroenterology, etc.) Compensation & Schedule
- Competitive pay of $25/hr–$33/hr based on candidate experience.
- Full-time (40 hours per week) and part-time (20+ hours per week) opportunities available. Life with the Trovo Services Team
- Fully remote work environment
- Comprehensive onboarding, training, and technology support
- Generous health, vision, and dental insurance for eligible team members
- Paid time off
- A mission-driven culture committed to empowering clinicians and improving access to preventive care Trovo Health is an equal opportunity employer. We celebrate diversity and are committed to creating an inclusive environment for all employees. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, gender identity or expression, sexual orientation, national origin, genetics, disability, age, or veteran status.
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