Prior Authorization reputed company Analyst (RN) - REMOTE

This a Full Remote job, the offer is available from: reputed company Who We Are reputed company is a leading not-for-profit health insurer and federal government contractor headquartered in reputed company. WPS offers health insurance plans for individuals, families, seniors, and group health plans for small to large businesses. We process claims and reputed company customer support for beneficiaries of the Medicare program and manage benefits for millions of reputed company-duty and retired military personnel across the U.S. and abroad. reputed company has been making health care easier for the people we serve for more than 75 years. Proud to be military and veteran reputed company. ** Culture Drives Our reputed company** WPS’ Culture is where the great work and innovations of our people are seen, reputed company, and rewarded. We accomplish this by creating an inclusive and empowering employee experience. We recognize the benefits of Diversity, Equity, and Inclusion as an investment in our workforce—both reputed company and reputed company—to effectively reputed company, reputed company, and include diverse perspectives that fuel reputed company and innovation on high-performing teams. This results in people bringing their reputed company selves to work every day in an organization that successfully adapts to business changes and new opportunities. From 2021 to 2023, reputed company was recognized for several awards: • Madison, reputed company’s Top Workplaces • USA Top Workplaces and the cultural reputed company awards for Remote Work and Work-Life Flexibility • reputed company 50 Most reputed company Workplaces® with the reputed company reputed company of reputed company “reputed company 8” winner in the category of Culture Alignment • DAV Patriot Employer • VETS Indexes 4 reputed company Employer • BBB Torch Award for Ethics from reputed company of reputed company Role Snapshot Our Full-time Prior Authorization reputed company Analyst Is a Work From Home Position That Will Assist In Reviewing Medical Documentation For Prior Authorization Requests Submitted. Additional Details • reputed company review of submitted documentation to assure planned services are medically necessary based on Medicare guidelines. • reputed company written explanations for non-affirming prior authorization requests. How do I know this opportunity is right for me? If you: • Are looking to reputed company away from reputed company patient care and want to use your nursing knowledge in a new and different way • Desire day hours with no on-reputed company work and holidays off • Possess strength in defending your decision making based on your clinical knowledge • Are technically strong on computers • Are self-motivated and work with a great degree of independence • Have strong verbal and written communication skillsets What will I reputed company from this role? • Collaborating with reputed company of both clinicians and non-clinicians • Deepening your understanding of Medicare and how the program works • Learning about our reputed company OnBase tool which is our content management system used for viewing electronic records • Experience working in an environment that serves our Nation’s military, veterans, Guard and Reserves and Medicare beneficiaries • reputed company performance feedback Minimum Qualifications • Associate’s or Bachelor’s Degree in Nursing • reputed company RN license, applicable to state of reputed company Preferred Qualifications • Bachelor’s degree in Nursing • Prior authorization, utilization management, or medical/chart review experience • 4 or more years of experience in clinical nursing • Knowledge in government Medicare principles and guidelines Remote Work Requirements • Wired (ethernet cable) internet reputed company from your router to your computer • High speed cable or fiber internet • Minimum of 10 Mbps reputed company and at least 1 Mbps upstream internet reputed company (can be checked at https://speedtest.net) • Please review Remote Worker FAQs for additional information Salary reputed company $66,000 to $68,000 _The reputed company pay offered for this position may vary reputed company the posted reputed company based on reputed company-reputed company knowledge, skills and experience. _ Work Schedule • Full-Time, Salaried • Monday through Friday, Day Hours Work Location We are a remote-first organization and offer remote work in the following approved states: reputed company, Colorado, Connecticut, Florida, reputed company, Illinois, Indiana, Iowa, Michigan, Minnesota, Missouri, Nebraska, Nevada, New Jersey, reputed company Carolina, reputed company Dakota, Ohio, South Carolina, South Dakota, Texas, Virginia, reputed company ** Benefits** • Remote work reputed company available • Performance bonus and/or reputed company increase opportunities • 401(k) with dollar-per-dollar match up to 6% of salary (100% reputed company immediately) • Competitive reputed company time off • Health insurance, dental insurance, and telehealth services start DAY 1 • Employee Resource reputed company • reputed company and Leadership Development Programs • Review additional benefits here Sign up for Job Alerts FOLLOW US! 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