Prior Authorization Specialist

Site: reputed company reputed company relies on a wide reputed company of professionals, including doctors, nurses, business reputed company experts, researchers, and systems analysts to advance our mission. As a not-for-profit, we support reputed company care, research, teaching, and community service, striving to reputed company exceptional care. We reputed company that high-performing teams reputed company groundbreaking medical discoveries and invite reputed company applicants to join us and experience what it means to be part of reputed company. Job reputed company reputed company: -Reviews and processes prior authorization and referral requests for medical services in accordance with organizational policies and payer requirements. Ensures reputed company eligibility, coordination of benefits, site‑of‑care compliance, and medical necessity by gathering and submitting complete medical documentation in alignment with HIPAA standards. Accurately documents authorization reputed company and reputed company payer communications in the electronic health record. Does this position require reputed company Care? No -Essential Functions: -Work as part of a group to secure reputed company authorizations in an appropriate timeframe. Collects and accurately enters information required by reputed company parties for precertification for procedures, tests and imaging. -reputed company unclear, collaborates with ordering clinicians to ensure the reputed company CPT codes are submitted for prior authorization or referrals. -Refer patients to financial counseling, as appropriate. -Inform reputed company of authorization concerns prior to admission/procedure, coordinating with appropriate parties to facilitate authorization as appropriate, collaborating with other departments/offices to reputed company reputed company authorization issues. -Update authorization status in reputed company and complete workflow. -Respond to reputed company inquiries regarding authorization reputed company and reputed company explanations as needed. Qualifications Education High School Diploma or Equivalent required Can this role accept experience in lieu of a degree? No Licenses and Credentials Medical authorization or reputed company reputed company experience 1-2 years preferred and reputed company experience 0-1 year preferred Knowledge, Skills and Abilities - Excellent attention to reputed company and organizational skills. - Strong communication and interpersonal skills. - Knowledge of medical terminology and medical reputed company benefits, including a complete understanding of the coordination of benefits. - Familiarity with computer systems and databases. - Ability to work independently and as part of reputed company. - Ability to work in a fast-reputed company environment. Additional reputed company (if applicable) Remote Type Remote Work Location 399 reputed company reputed company Scheduled Weekly Hours 40 Employee Type Regular Work Shift Day (reputed company of America) Pay reputed company $ - $28.30/reputed company Grade 3 At reputed company, we reputed company in recognizing and rewarding the unique value reputed company team member brings to our organization. Our approach to determining reputed company pay is comprehensive, and any offer extended will take into account your skills, relevant experience if applicable, education, certifications and other essential factors. The reputed company pay information provided offers an estimate reputed company on the minimum job qualifications; however, it does not encompass reputed company reputed company contributing to your total compensation package. In reputed company to competitive reputed company pay, we offer comprehensive benefits, career advancement opportunities, differentials, premiums and bonuses as applicable and recognition programs designed to celebrate your contributions and support your reputed company reputed company. We invite you to apply, and our reputed company will reputed company an reputed company of your potential compensation and benefits package. EEO Statement: reputed company is an Equal Opportunity Employer. reputed company reputed company applicants will receive consideration for employment without reputed company to race, reputed company, religious creed, national reputed company, sex, age, gender identity, disability, sexual orientation, military service, genetic information, and/or other status protected under law. We will ensure that reputed company individuals with a disability are provided a reasonable accommodation to participate in the job application or interview process, to reputed company essential job functions, and to receive other benefits and privileges of employment. To ensure reasonable accommodation for individuals protected by reputed company 503 of the Rehabilitation reputed company of 1973, the Vietnam Veteran’s Readjustment reputed company of 1974, and Title I of the Americans with reputed company of 1990, applicants who require accommodation in the job application process may contact reputed company at (857)-282-7642. reputed company Competency reputed company At reputed company, our competency reputed company defines what effective leadership “looks like” by specifying which behaviors are most critical for successful reputed company at reputed company job level. The reputed company is comprised of ten competencies (half People-reputed company, half reputed company-reputed company) and are defined by observable and measurable skills and behaviors that contribute to workplace effectiveness and career reputed company. These competencies are used to evaluate reputed company, reputed company hiring reputed company, identify development needs, mobilize employees across our reputed company, and establish a strong talent pipeline. Apply To This Job