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Prior Authorization Specialist
4 months ago
A-Line Staffing is now hiring a remote Prior Authorization Specialist with a major health plan company. This would be full time / 40+ hours per week.
Prior Authorization Specialist Compensation
- The pay for this position is $23 per hour
- Benefits are available to full-time employees after 90 days of employment
- A 401(k) with a company match is available for full-time employees with 1 year of service on our eligibility dates
Prior Authorization Specialist Highlights
- This position is a contract assignment with potential to hire on permanently based upon attendance, performance, and business needs
- The required shift for this position is: Training will be Mon-Fri-8-5pm for first 6 weeks. After training, need to be very flexible. Shifts will be assigned based on business needs. You need to be able to work the weekends and as early as 6am. You may also work a later shift which is 11-7:30 pm or 12-8:30 pm PST . If working weekends, you will receive days off during the week
Prior Authorization Specialist Responsibilities
- Supports the authorization review process by researching and documenting necessary medical information such as history, diagnosis, and prognosis based on the referral to the clinical reviewer for determination
- Verifies member insurance coverage and/or service/benefit eligibility via system tools and aligns authorization with the guidelines to ensure a timely adjudication for payment
- Performs data entry to maintain and update various authorization requests into utilization management system
- Supports and processes authorization requests for services in accordance with the insurance prior authorization list and routes to the appropriate clinical reviewer.
- Working out of a fax notification queue
- May need to be able to make and take calls if needed
- Must review authorizations and be able to quickly review and build an inpatient authorization, enter data and route to correct team
- This role is supporting the Hospital Notification Unit
- Role is Initiating authorizations for outpatient and inpatient services.
- Review referrals from FileNet and enter Trucare.
- Production based role ,30 per day to start and then expectation will increase as they are more familiar with the role and then will be expected to complete 60 per day
- Monthly report cards are given and they review quality and production with the supervisor.
- Must be able to communicate and collaborate effectively
- Must be detail oriented, availability to work weekend and late shifts and have strong communication skills.
- Must be able to adapt quickly
- Additional duties as assigned
Prior Authorization Specialist Requirements
- High school diploma or equivalent experience
- 2+ years of prior authorization experience is a must
- Attendance is mandatory for the first 90 days
If you think this Prior Authorization Specialist position is a good fit for you, please reach out to me - feel free to e-mail aortiz@alinestaffing.com or apply to this posting
