MedHire

Prior Authorization Specialist

Specialists who handle the entire prior authorization lifecycle — from submission to approval — across commercial and government payers.

−38%
PA turnaround
94%
Approval rate
PA #PA-88312
In progress
  1. PA submitted
    Mon 9:14a
    CPT 70553 · MRI brain
  2. Payer ack
    Mon 1:02p
    Aetna ref #PA-88312
  3. Add'l clinical requested
    Tue 11:30a
    Sent within 4h
  4. Peer-to-peer scheduled
    Wed 8:45a
    Dr. Park · 2:00p
  5. Approval expected
    —
    Within 24h
What they own

A defined scope, measured weekly.

Every Prior Authorization Specialist on your team owns a clear scope of work, tracked against the metrics above and reviewed in a weekly business review.

Submit PA requests with complete clinical info
Follow up on pending authorizations
Coordinate peer-to-peer reviews when needed
Document approvals in the EHR
Day 1 → Day 7

How a Prior Authorization Specialist gets up to speed.

Step 1

Specialty-specific PA criteria training

Step 2

Shadow 5 active PA cases

Step 3

First independent submission by day 4

Software fluency

Day-one fluent in your stack.

Pre-trained on the platforms your practice already runs. We'll match for primary fluency, then cross-train as needed.

Athenahealth Epic CoverMyMeds

Add a Prior Authorization Specialist to your team.

Pre-vetted, HIPAA-aware, fluent in your software. Live in under two weeks.

Book a demo