Prior Authorization Coordinator

1 week ago


Detroit, Michigan, United States w3r Consulting Full time
Remote position, but onsite required for training

**Key Responsibilities:**

* Support providers and UM reviewers with prior authorization requests for post-acute care services.
* Manually enter authorization requests into Care Management systems, following rules and algorithms embedded in the care management system to administratively approve prior authorization requests.
* Work with providers to secure discharge plans, Notice of Non-Medical Coverage, Durable medical equipment, and other home supports required for discharge planning.
* Support scheduling physician to physician calls.
* Assist with appeal processes for CMS designated Quality Improvement Organization appeals, including logging all appeal activities.

**Qualifications:**

* 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.

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