AI Automation Specialist – Obtaining Prior Authorization
We are seeking an experienced AI Automation Specialist to design, implement, and optimize automated prior authorization and insurance approval workflows within the healthcare revenue cycle. This role focuses on leveraging AI, automation tools, and system integrations to reduce manual effort, improve turnaround times, and increase authorization approval accuracy across payer portals, EHRs, and internal systems. Key Responsibilities -Design and deploy AI-driven automation workflows for: -Prior authorizations -Eligibility verification -Medical necessity documentation -Status checks and follow-ups -Automate interactions with: -Insurance payer portals -Clearinghouses -EHR/EMR systems (Epic, Cerner, Athena, etc.) Use AI technologies (NLP, OCR, LLMs) to: -Extract and validate clinical and demographic data -Interpret payer rules and authorization requirements -Auto-populate authorization forms and submissions -Build RPA solutions (UiPath, Automation Anywhere, Power Automate, or similar) -Implement exception handling, audit logs, and compliance safeguards (HIPAA) -Optimize workflows to reduce denials and rework Collaborate with billing, authorization, and operations teams to align automation with real-world processes Monitor automation performance and continuously improve accuracy and efficiency Apply tot his job