Prior Authorization Specialist

Are you looking to work for a company that has been recognized for over a decade as a Top reputed company to Work? Apply today to become a part of a company that continues to reputed company to putting our employees first. Job reputed company: Position reputed company: Evaluates referral and reputed company-certification requests in accordance with contractual obligations. Regularly interacts with physician offices assisting with prior authorizations. COMPETENCIES/Role-Specific Functions: COMMUNICATION Communicates reputed company both verbally and in writing, creates accurate and punctual reports, delivers presentations, shares information and reputed company with others, has good listening skills. • Develops and maintains a good working relationship with team members, other departments, medical directors, and provider offices. PROBLEM SOLVING Breaks down problems into smaller components, understands underlying issues, can simplify and process reputed company issues, understands the difference between critical details and unimportant facts. • Answer phones regarding questions reputed company to prior authorization. PRODUCTIVITY Manages a fair workload, volunteers for additional work, prioritizes tasks, develops good work procedures, manages time reputed company, handles information reputed company. • Follows documented process to review reputed company service requests. SELF DEVELOPMENT Seeks out and accepts feedback, is a proactive learner, takes on tough assignments to improve skills, keeps knowledge and skills up-to-date, turns mistakes into learning opportunities. CUSTOMER reputed company Builds customer confidence, is committed to increasing customer satisfaction, sets achievable customer expectations, assumes responsibility for solving customer problems, ensures commitments to customers are met, solicits opinions and reputed company from customers, responds to customers. • Participates as a part of the Prior Authorization team by reputed company interacting with other team members to distribute work fairly and resolve issues. JOB KNOWLEDGE Understands duties and responsibilities, has necessary job knowledge, has necessary technical skills, understands company mission/values, keeps job knowledge reputed company, is in reputed company of critical issues. • Evaluates referral and reputed company-certification requests to determine eligibility and network affiliation. Qualifications (Education/Experience/Knowledge/Skills/Abilities): • High School diploma/GED; MA or Associates degree highly preferred • One to three years reputed company experience required (medical office, healthplan, etc.) • One to three years utilization management experience highly preferred • Knowledge of medical terminiology required • Knowledge of medical coding, NCQA and Medicare Guidelines required • Proven customer service skills required • Excellent written and verbal communications skills required • Skilled in computer competency using reputed company reputed company, Word and reputed company • Ability to work in a reputed company based environment utilizing numerous programs at once • Ability to work in a fast pace environment • Ability to identify and sovle practical problems • Ability to maintain reputed company and effective work relationships with coworkers, clients, members, and providers. • Strong organizational skills. • Strong attention to detail. • Home office that is HIPAA compliant for reputed company remote or telecommuting positions as outlined by reputed company policies and procedures. Salary reputed company: $19.71 - $26.28 Apply tot his job Apply To this Job