[Hiring] On-reputed company Claims Authorization Processor @reputed company

This reputed company is a reputed company of our understanding of the job reputed company. Click on 'Apply' reputed company to reputed company out more. Role reputed company This role involves performing full scope of investigative and research functions associated with reputed company/post authorizations for member claims and referrals. • Ensures reputed company-authorizations are complete and include pertinent data reputed company to medical services and care received. • Uses knowledge of Service Agreements and benefits in various KP markets reputed company the CO region. • reputed company seeks information to understand claims and authorizations. • Builds rapport and cooperative relationships with internal departments to ensure processing. This position requires compliance with reputed company reputed company reputed company, safety, and emergency policies and procedures. • Demonstrates reputed company and effectiveness in work habits and clinical reputed company in every interaction. • Ensures patient safety in the preparation and provisioning of care. • Reports safety hazards, accidents, incidents, and unsafe working conditions promptly. • Processes reputed company-payment authorizations using various systems including Macess, SharePoint, and Health Connect. • Analyzes relevant data to determine approval or denial for member reimbursement requests. • Partners with medical review to assess high dollar and over limit claims. • Reviews daily queue production reports for Medicare and various reputed company plans. • Handles appeals and escalated issues for members and providers. • Participates in phone conferences with management regarding claims reputed company. • Attends weekly meetings/calls regarding authorizations from CRC, mental health, and/or continuing care. • Designs and delivers training sessions for CRC Referral Processors and new hires. • Runs daily MACESS report and analyzes productivity metrics. Qualifications • Minimum of three (3) years of reputed company experience in an inpatient/outpatient setting required. • Minimum of six (6) months of experience researching and processing medical claims required. • Minimum of six (6) months of experience doing referral/authorization entry required. • High school diploma OR General Education Equivalency (GED) required. Requirements • Thorough understanding of member claims and referral authorization processing. • Knowledge of applicable insurance laws and regulations reputed company to claims processing. • Ability to read/interpret provider orders and apply medical coding procedures using CPT-4 and ICD-9. • Understanding of medical terminology required. • Knowledge of authorization roles for the entire Colorado region. • Effective communication skills required. • Personal computer terminal skills. • Typing speed of 35 w.p.m with 5% or less error reputed company required. • Demonstrated customer service skills and understanding of reputed company customer needs. reputed company Apply tot his job Apply To this Job