Authorization Rep

5 days ago

Emeryville, United States APR Consulting Full time
Authorization Rep

  • Location: Emeryville, California
  • Type: Contract
  • Job #78606
APR Consulting, Inc. has been engaged to identify a Authorization Rep

Location: Emeryville, CA 94608 - Remote 100%
Position: Authorization Rep
Unit: Administrative
Pay Rate: $24.50 /hr.
Duration: 26 weeks
Expected Shift: Day 5×8-Hour: 9 AM - 5 PM

Job Responsibilities:
  • Verify patient eligibility and coordinate benefits.
  • Ensure insurance coverage and determine if prior authorization is required.
  • Obtain necessary authorizations and document them in the patient's electronic medical record.
  • Respond to patient inquiries regarding authorizations within standard turnaround times.
  • Verify patient eligibility and facility approval, following up to obtain authorizations promptly and recording authorization numbers as instructed.
  • Collect patient demographics and clinical data for each authorization and contact insurance companies or review organizations to secure approvals.
  • Enter authorization requests into the patient's electronic health record with correct codes, treatment types, and provider details.
  • Communicate with physicians and department staff when authorization issues arise.
  • Interface with patients or third-party payers to gather information and communicate approvals, denials, or appeals.
  • Provide excellent customer service by addressing provider, staff, and patient concerns courteously and documenting interactions appropriately.
  • Cross-train team members to ensure consistent coverage and provide backup support as needed.
Education Requirements:
  • Equivalent experience may be accepted in place of the required degree or diploma.
  • High School Diploma or equivalent education/experience.
Experience:
  • 1 year of recent relevant experience.
Skills and Knowledge:
  • Understanding of medical terminology, CPT/HCPCS/ICD-9 coding.
  • Knowledge of medical terminology and anatomy.
  • Ability to exercise discretion and make independent judgments, with guidance on significant departures from guidelines.
  • Proficiency in Microsoft Office programs, including Excel and Word.
  • Ability to maintain composure during challenging interactions.
  • Active listening skills, interpersonal skills, and telephone communication skills.
  • Strong organizational skills, attention to detail, and follow-up abilities.

Our client is the one of the largest Healthcare Staffing Provider in the United States, to be assigned at one of their affiliated hospitals/healthcare facilities.

This particular client is requiring that all new hires show proof of vaccination. However, accommodations may be made for those with disabilities or religious reasons who cannot obtain a vaccine.

Since 1980 APR Consulting, Inc. has provided professional recruiting and contingent workforce solutions to a diverse mix of clients, industries, and skill sets nationwide.

We are an equal opportunity employer, and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity or expression, pregnancy, age, national origin, disability status, genetic information, protected veteran status, or any other characteristic protected by law.

Don't miss out on this amazing opportunity If you feel your experience is a match for this position please apply today and join our team. We look forward to working with you