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Prior Authorization Specialist
2 months ago
STRATEGIC STAFFING SOLUTIONS (S3) HAS AN OPENING
Strategic Staffing Solutions is currently looking for Prior Authorization Specialists for a contract opportunity with one of our largest clients located in Detroit, MI
Title: Prior Authorization Specialists – multiple openings
Location: Detroit, MI (2 weeks onsite training then 100% remote)
Duration: 12+ Months
Role Type: W2 contract engagement
ROLE SUMMARY
Medicare Advantage Post-Acute Care Specialist:
- Support healthcare providers and UM reviewers with prior authorization requests for post-acute care services.
- Includes manually entering authorization requests into healthcare system, following rules and algorithms embedded in the care management system to administratively approve prior authorization requests.
- May work with providers to secure discharge plans, Notice of Non-Medical Coverage, Durable medical equipment, and other home supports required for discharge planning.
- May support scheduling physician to physician calls.
- Will support appeal processes for CMS designated Quality Improvement Organization appeals including logging all appeal activities.
Requirements:
- High School Graduate or GED equivalent required.
- Two (2) years of college preferred.
- Two (2) years’ experience as medical assistant, care technician, post-acute care and home health care support staff or ancillary services in other health care related field preferred.
- Knowledge of post-acute care functions and processes or discharge readiness activities may be preferred for some positions.