Prior Authorization Specialist

Before you apply

Job source

Himalayas

Applying on

adaptivebiotech.com

Workplace

Fully remote

US state

Nationwide remote

Category

Administrative

Link last checked

2 hours ago

Posted

1 month ago

Closes

11/26/2026

1. 1. Tailor your resume to this posting — it takes about a minute and noticeably improves your match score.
2. 2. Click One-Click Apply. We open the posting directly on adaptivebiotech.com in a new tab — Remote Me never charges for or intermediates an application.
3. 3. Create or sign in to the employer's applicant account, upload your resume, and submit their form.
4. 4. Come back and hit Save so this role stays in your dashboard — we'll notify you if the posting closes or the link breaks.

About the role

At Adaptive, we’re Powering the Age of Immune Medicine. Our goal is to harness the power of the adaptive immune system to transform the way diseases are diagnosed and treated. As an Adapter, you’ll have the opportunity to make a difference in people’s lives. With Adaptive, you’ll create a career highlight through collaboration with bright, curious colleagues working at the apex of innovation and application. It’s time for your next chapter. Discover your story with Adaptive. Position Overview The Prior Authorization Specialist is responsible for obtaining insurance approvals for Adaptive Biotechnologies clonoSEQ MRD Assay. This role ensures timely and accurate processing of prior authorizations to facilitate patient access to essential laboratory services. The specialist acts as a liaison between the laboratory, healthcare providers, and insurance companies to minimize delays and optimize reimbursement. Key Responsibilities and Essential Functions Prior Authorization Management Submit and track prior authorization requests for clonoSEQ Review clinical documentation to ensure compliance with payer requirements. Communicate with insurance companies to resolve authorization issues promptly. Documentation & Compliance Maintain accurate records of all authorization activities in the Adaptive’s RCM system. Ensure compliance with HIPAA and other regulatory guidelines. Insurance & Payer Coordination Stay updated on payer policies related to molecular and genetic testing. Identify and escalate trends in denials or delays to management for resolution. Workflow Optimization Work closely with billing and reimbursement teams to ensure smooth claims processing. Assist in developing best practices for prior authorization workflows. All other duties as assigned Position Requirements (Education, Experience, Other) Required High school diploma or equivalent. Minimum 2 years in prior authorization, medical billing, or insurance verification. Strong understanding of insurance processes and medical terminology. Excellent communication and organizational skills. Proficiency in EMR systems and Microsoft Office Suite. Attention to detail and accuracy. Ability to work independently and manage multiple priorities. Strong problem-solving and critical thinking skills. Preferred Associate or bachelor’s degree. Experience with Careviso, Glidian and Quadax systems Experience in molecular or genetic testing is preferred. Working Conditions Flexibility to work out of standard hours when necessary, including nights & weekends, holiday etc. Physical Requirements This job is primarily completing work from a desk. Compensation Hourly Rate: $21.68 - $23.99 Other compensation elements include: equity grant bonus eligible ALERT: Malicious groups posing as Adaptive employees have recently used fraudulent email aliases to extend employment offers, provide fake documents, and request sensitive personal and financial information. Legitimate Adaptive employment opportunities are initiated through our careers page and extended after multiple interviews with verified employees. Adaptive does not ask new hires to purchase anything out-of-pocket, including home office supplies and equipment. Interested in this position, but don’t meet all the requirements? Adaptive is committed to building diverse, equitable, and inclusive teams across our organization. Please consider applying even if your experience doesn’t match all the qualifications; you may be the exact candidate we’re searching for! Adaptive is not currently sponsoring candidates requiring work authorization support for this position. Adaptive’s posted compensation information includes a base salary (or hourly rate) range and summary of other available total compensation. The base salary range represents a minimum-to-maximum salary (or hourly rate) available to candidates upon extension of offer. Base salary is thoughtfully considered upon offer and is determined through multiple evaluation checks throughout the inter

Adaptive Biotechnologies is hiring remote talent through Remote Me. All listings are vetted for legitimacy.