Prior Authorizations Specialist

4 weeks ago

Salt Lake City, United States North Coast Medical Supply LLC Full time

Job Type

Full-time

Description

About our Company

Advanced Diabetes Supply® was founded on the bold principle of creating a knowledgeable, reliable and demonstrably superior diabetes supply company. Our approach, coupled with a commitment to service and innovation, has catapulted Advanced Diabetes Supply® to a national leader in the industry. Creating high-performance, adaptive teams requires a relentless commitment to hiring the best. We strive to maintain a casual, fun environment whenever possible, but we don't just play around. We work hard every day to provide a positive work culture and respectful atmosphere. The standards we set for ourselves are high, and we love to be challenged If you enjoy working in a collaborative environment, have a passion for excellence and a bias for action, we may be just what you've been looking for.

Interested in learning more about our company and its culture? Visit us at www.northcoastmed.com

Essential Functions

  • Review incoming authorization requests and verify patient eligibility and benefits.
  • Initiates prior authorization requests via phone, fax, or online portals.
  • Tracks and follows up on the status of submitted authorizations.
  • Communicates approval or denial outcomes to healthcare providers and patients.
  • Maintains accurate records and documentation of all authorization activities.
  • Collaborates with the billing and clinical teams to ensure the accuracy of information.
  • Complies with HIPAA rules, appropriately safeguarding PHI or other private & confidential information.
  • Maintains accurate and detailed notes in the company system.
  • Adapts quickly to frequent process changes and improvements.
  • Is reliable, engaged, and provides feedback to improve processes and policies.
  • Attends all department, team, and weekly company meetings as required.
  • Appropriately routes incoming calls when necessary.
  • Meets company quality standards.
  • Embraces and exemplifies ADS core values:
    • We put our people first.
    • We serve our members with passion.
    • We take ownership.
    • We pursue excellence.
    • We never stop growing.
Other Responsibilities
  • May perform any additional responsibilities or special projects as required.
  • Duties and responsibilities may be subject to change based on the needs of the department.
Requirements
  • High School diploma or equivalent (GED)
  • 6 months experience in prior authorizations, or related field.
  • Knowledge of insurance, billing, and processing claims
  • Basic knowledge of insurance portals; familiarity with a variety of medical and/or insurance terms or practices
  • Proficiency in basic math and business calculations
  • Working knowledge of computer/data entry with the ability to learn new systems
  • Basic level of MS Office proficiency
Expected Competencies
  • Friendly, professional, and effective communication skills; able to calmly present solutions in challenging situations.
  • Proactive identification of challenges, and solution-oriented approach to problem solving.
  • Service orientation and aptitude to aptitude to resolve insurance and/or patient matters.
  • Effective analytical skills: able to use inductive and deductive reasoning to anticipate outcomes.
  • Self-directed accountability and reliability
  • Effective communication, and interpersonal skills, with the ability to influence and collaborate effectively with cross-functional teams.
  • Able to manage and prioritize multiple tasks/projects, work autonomously, and meet deadlines.
  • Able to work well in a team environment that promotes inclusiveness and communication among team members.
  • Communication using both verbal and written English proficiency.
  • Cultural competence
Physical Demands

The physical demands described below are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable employees with disabilities to perform the essential functions.

While performing the responsibilities of the job, the employee is required to remain in a stationary position most of the time (stand or sit). While performing the duties of this Job, the employee is regularly required to sit; use hands to finger, handle, or feel; and talk or hear. The employee is frequently required to stand, walk, and reach with hands and arms. The employee is occasionally required to stoop, kneel, crouch, or crawl. The employee must occasionally lift and/or move up to 15 pounds. Specific vision abilities required by this job include close vision and ability to adjust focus.

Other Requirements
  • Candidates must successfully pass a background check.
  • Candidates must be able to provide proof of eligibility to work in the United States.
Pay Range and Compensation Package

Pay ranges may vary depending on location. Actual compensation depends on education, experience, and relevant skills. In addition, benefits include:
  • Health, Dental & Vision options
  • FSA and HSA plan with Employer Contribution
  • Employer paid EAP
  • 401k with 4% Company Match
  • Discretionary Profit-Sharing Plan
  • Paid Time Off (PTO) Including 7 Paid Holidays and a Birthday Holiday
  • On-Site Gym
  • In-house Training Programs
  • A fun culture in a fast-growing organization


Equal Opportunity Statement

Advanced Diabetes Supply® provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type based on race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws. This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation, and training.

  • Prior Authorization Rep

    1 month ago

    Salt Lake City, United States Intermountain Healthcare Full time

    Job Description: Responsible for obtaining prior authorizations for patients and physician offices. Obtains and inputs all necessary demographic, financial, and clinical information from the patient, representative or physicians office. This position is remote to local Utah applicants only. This position performs prior authorizations for patients and...

  • Prior Authorization Representative I

    1 month ago

    Salt Lake City, United States University of Utah Full time

    University Medical Billing (UMB) is a fully remote department that is viewed as the premier billing office for the University of Utah School of Medicine, serving over 1,800 providers and 30 different specialties across Utah and surrounding states. We Authorization, Representative, Insurance, Radiology, Technology, Education, Medical, Patient

  • Hobson Prior | Senior Director of Regulatory Affairs | new york city, ny

    4 weeks ago

    new york city, United States Hobson Prior Full time

    Hobson Prior is seeking a motivated Senior Regulatory Affairs Specialist focused on device development. The successful candidate will ensure regulatory compliance and support the development and commercialization of innovative medical devices. This role requires a strong understanding of regulatory requirements and experience in device development within the...

  • Hobson Prior | Senior Director of Regulatory Affairs | new york city, ny

    4 weeks ago

    new york city, United States Hobson Prior Full time

    Hobson Prior is seeking a motivated Senior Regulatory Affairs Specialist focused on device development. The successful candidate will ensure regulatory compliance and support the development and commercialization of innovative medical devices. This role requires a strong understanding of regulatory requirements and experience in device development within the...

  • Authorization Specialist

    1 week ago

    Oklahoma City, United States BrightSpring Health Services Full time

    Prior Authorization SpecialistJob LocationsUS-OK-OKLAHOMA CITYIDLine of BusinessAmeritaPosition TypeFull-TimeOur CompanyAmeritaOverviewCome join our closed-door specialty infusion pharmacy! Amerita is a leading provider of Specialty Infusion services focused on providing complex pharmaceutical products and clinical services to patients outside of the...

  • Pharmacy Technician-Prior Authorizations

    4 weeks ago

    Lake Chesterfield, United States Mercy Full time

    We’re a Little Different Our mission is clear. We bring to life a healing ministry through our compassionate care and exceptional service. At Mercy, we believe in careers that match the unique gifts of unique individuals – careers that not only make the most of your skills and talents, but also your heart. Join us and discover why Modern Healthcare...

  • Authorization Specialist

    3 weeks ago

    Oklahoma City, United States BrightSpring Health Services Full time

    Prior Authorization SpecialistJob LocationsUS-OK-OKLAHOMA CITYIDLine of BusinessAmeritaPosition TypeFull-TimeOur CompanyAmeritaOverviewCome join our closed-door specialty infusion pharmacy! Amerita is a leading provider of Specialty Infusion services focused on providing complex pharmaceutical products and clinical services to patients outside of the...

  • Medical Authorization Specialist, Claims and Benefits

    3 weeks ago

    Garden City, New York, United States METRO PHYSICAL & AQUATIC THERAPY Full time

    About Metro Physical & Aquatic TherapyMetro Physical & Aquatic Therapy is a comprehensive multidisciplinary company offering various therapy services. Our mission is to invest in our team and provide the best workplace environment possible.Job Summary:We are seeking a motivated Medical Authorization Specialist to join our Garden City office. As an NF/WC...

  • Medical Operations Specialist

    5 days ago

    Salt Lake, Utah, United States CE Medical Group Full time

    CE Medical Group, a leading healthcare consulting firm, seeks an experienced Part-time Medical Office Operations Consultant to join their team.About the RoleThis role involves guiding medical staff in mastering insurance verification, prior authorization, and patient intake processes. The ideal candidate will create engaging training materials, lead...

  • Medical Office Operations Specialist

    3 weeks ago

    Salt Lake, Utah, United States CE Medical Group Full time

    CE Medical Group, a leading healthcare consulting firm with 18 years of experience, is seeking a highly skilled Part-time Medical Office Operations Consultant to join our team. This key role will focus on training and developing our medical staff in insurance verification, prior authorization, and patient intake processes.About the JobThis is a dynamic...

  • Medical Operations Consultant

    4 weeks ago

    Salt Lake City, United States CE Medical Group Full time

    Remote Medical Specialists is teaming up with CE Medical Group, a trusted leader in healthcare consulting for the past 18 years. We're on the lookout for a passionate and experienced Part time Medical Office Operations Consultant to bring their expertise to our team!As our go-to trainer, you'll guide our Medical Assistants, Receptionists, Insurance...

  • Medical Operations Consultant

    2 weeks ago

    Salt Lake City, United States CE Medical Group Full time

    Remote Medical Specialists is teaming up with CE Medical Group, a trusted leader in healthcare consulting for the past 18 years. We're on the lookout for a passionate and experienced Part time Medical Office Operations Consultant to bring their expertise to our team! As our go-to trainer, you'll guide our Medical Assistants, Receptionists, Insurance...

  • Pharmaceutical Clinical Services Specialist

    14 hours ago

    Salt Lake, Utah, United States American Cybersystems Full time

    About This OpportunityAs a Pharmaceutical Clinical Services Specialist at American Cybersystems, you will be responsible for evaluating prior authorization requests, appeals, and retrospective claim reviews to ensure accurate coverage recommendations. You will also provide guidance and support to medical directors, case managers, and other staff members on...

  • Housekeeping Specialist

    3 weeks ago

    Salt Lake, Utah, United States MBK Senior Living Full time

    Job Title:Housekeeping SpecialistSalary:$45,000 - $55,000 per yearAbout the Job:We are seeking a highly motivated and detail-oriented Housekeeping Specialist to join our team at MBK Senior Living. As a Housekeeping Specialist, you will be responsible for maintaining the cleanliness and organization of resident apartments, common areas, and...

  • Transplant Support Specialist

    14 hours ago

    Salt Lake, Utah, United States Intermountain Health Full time

    About the RoleThe Transplant Support Specialist is responsible for facilitating effective clinic organization and patient care by serving as a communication link between patients, staff, physicians, hospital departments, or other outside healthcare entities.This role requires strong organizational and communication skills, with the ability to develop and...

  • Eligibility Specialist

    3 weeks ago

    Salt Lake City, United States Housing Authority of Salt Lake Full time

    Job DescriptionJob DescriptionDescription:The Housing Authority of Salt Lake City (HASLC), is a federally funded Special Purpose Government Agency, created to provide rent subsidies, and promote affordable housing for low-income persons residing in Salt Lake City. HASLC is the largest public housing authority in the state of Utah and the largest provider of...

  • Insurance Verification Training Expert

    6 days ago

    Salt Lake, Utah, United States CE Medical Group Full time

    CE Medical Group is a trusted leader in healthcare consulting, and we're now seeking a skilled Part-time Medical Office Operations Consultant to help us achieve our goals.About the OpportunityThis role offers a chance to work closely with our medical staff, developing comprehensive training programs that enhance their skills and knowledge. You'll also...

  • Specialist, Software Engineer

    2 months ago

    Salt Lake City, United States L3 Technologies Full time

    Job Title: Specialist, Software Engineer Job Location: Salt Lake City, UT Job Code: 16382 Job Schedule: 9/80, every other Friday off Job Description: L3Harris is actively seeking a highly motivated and dynamic individual to join our team as a Software Engineer for the System Software Integration and Test Team. In this role, you will develop software...

  • Specialist, Software Engineer

    2 months ago

    Salt Lake City, United States L3Harris Full time

    Job Title: Specialist, Software Engineer Job Location: Salt Lake City, UT Job Code: 16382 Job Schedule: 9/80, every other Friday off Job Description: L3Harris is actively seeking a highly motivated and dynamic individual to join our team as a Software Engineer for the System Software Integration and Test Team. In this role, you will develop software...

  • Medical Operations Coordinator Specialist

    3 weeks ago

    Salt Lake, Utah, United States CE Medical Group Full time

    CE Medical Group Medical Operations CoordinatorWe are seeking an experienced Medical Operations Coordinator to join our team at CE Medical Group, a trusted leader in healthcare consulting. The ideal candidate will have a strong background in medical office operations and a passion for training and supporting others.About the Role:This is a full-time position...