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Authorization Specialist II
3 months ago
Dean’s Professional Services is now hiring a qualified, patient-care-focusedAuthorization SpecialistIIto work in a HealthcareFacility inthe Texas area. – Remote-Must Reside in Texas
We are on a mission to create care that’s more convenient and professional. With solutions that are value-based and patient-centered. To accomplish this, we are looking for individuals who share our sense of excellence and are ready to embrace new opportunities
The Authorization Specialist is responsible for supporting the prior authorization request to ensure all authorization requests are addressed properly and in the contractual timeline. Aids utilization management team to document authorization requests and obtain accurate and timely documentation for services related to the members healthcare eligibility and access.
Job Responsibilities:
- Receive faxes, triage them, and send out to the appropriate teams within Superior HealthPlan
- Supporting intake department to streamline the intake process
- Candidate needs to be comfortable typing fast and inputting data through the day
- Enters pertinent claims information from source documents
- Corrects entries where indicated.
- Maintains appropriate records, files, documentation, etc.
- Processing for teams including Concurrent Review, Behavioral Health, and Medicare, etc. – department is open 7 days/week because of this level of exposure to the business.
- Supports authorization requests for services in accordance with the insurance prior authorization list
- Supports and performs data entry to maintain and update authorization requests into utilization management system
- Assists utilization management team with ongoing tracking and appropriate documentation on authorizations and referrals in accordance with policies and guidelines
- Contributes to the authorization review process by documenting necessary medical information such as history, diagnosis, and prognosis based on the referral to the clinical reviewer for determination
- Remains up-to-date on healthcare, authorization processes, policies and procedures
- Performs other duties as assigned
- Complies with all policies and standards
- Team will process anywhere from 3,500 to 4,000 faxes per day – need to get the faxes out to other teams within 1-2 hours of receiving, depending on the form
- 10,000 keystrokes an hour – 50 to 60 WPM, very fast-paced team
Job Requirements:
- Must Reside in Texas
- High school diploma or equivalent – Required
- 3 months to 1 year of data processing or clerical experience - Preferred
- Understanding of medical terminology and insurance preferred.
- Customer Service – Required
- Data Entry Experience - Required
Job Details:
- Schedule: 8:00 am - 5:00 pm
- Starting at $19/hr. (Based on experience)
- Full benefits – healthcare, dental, vision, 401k program.
- Temp-to-Hire opportunity.
Dean’s Professional Services is a national, award-winning staffing solutions firm. Since 1993, DPS has placed over 45,000 professionals across the nation. We work with our clients to provide placement opportunities that match your skill, experience, and personality. For more information, please visitwww.deansprofessionalservices.com.
