Medical Authorization Auditor

Description

Position Summary: We are seeking a Medical Authorization Auditor to evaluate requests for medical and surgical services, guide authorizations, and analyze reimbursement requests. Key Highlights: 1. Transform medical judgment into decisions that ensure appropriate care 2. Evaluate requests for medical and surgical authorizations 3. Establish a synergistic relationship with providers **Date:** Aug 26, 2026 **Location:** Federal Capital, AR **Company:** Swiss Medical Group At Swiss Medical, we work every day to help people live longer and better. More than 4 million people trust us, and behind each story is a team of over 16\.500 professionals who choose daily to care for, accompany, and transform lives. To continue positively impacting more people’s lives, we seek to add a Medical Authorization Auditor to the Medical Services and Audit Management team of Swiss Medical Private Medicine. Your Impact Every authorization is a decision that can make a difference in a person’s care. In this role, you will be able to transform your medical judgment into decisions that ensure appropriate, timely, and high-quality care for each patient. **Responsibilities:** Evaluate requests for authorizations of outpatient and inpatient medical and surgical services. Guide authorizations based on medical service cost. Establish a synergistic relationship with panel providers. Assess the validity and conditions of reimbursement requests. Analyze the validity and cost-effectiveness of authorizations for high-cost materials/prostheses/orthoses. **Requirements:** Physician with clinical or surgical specialty. Completed training in Medical Auditing or Health Management. Minimum 2 years’ experience with private health insurers. Advanced Excel proficiency. Benefits ‍️ Health insurance coverage for you and your immediate family. Preferential access when contracting Swiss Medical products and services (surety, home, auto, retirement, life, savings, and Swiss Medical Cells insurance). University discounts and access to our corporate e\-learning platform. Free vaccination campaign. ️‍️ Gym coverage through the Wellhub network. Corporate discounts at cinemas, theaters, travel agencies, restaurants, spas, and other categories. **Work Schedule and Location:** Monday–Thursday, 9 AM–6 PM; Friday, 9 AM–5 PM. CABA **Work Modality:** Hybrid Join a company that works every day to help millions of people live longer and better.