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Care Partners Innovation Specialist
2 months ago
HonorHealth is seeking a skilled Prior Authorization Specialist to join our team. As a key member of our Utilization Management Department, you will play a critical role in ensuring the timely completion of authorization requests for services.
Responsibilities- Review referral and admission requests, verifying patient eligibility and benefit information within our billing system.
- Coordinate the PA process in MCG software, ensuring accurate documentation and adherence to nationally recognized criteria and guidelines.
- Approve requests or escalate to the Medical Director/designee as necessary, maintaining a productivity case load of 10-15 prior auth processing per day.
- Communicate with medical office staff and referring physicians to obtain necessary information and resolve PA issues.
- Maintain accurate logs of PA authorizations within software and ensure compliance with organization policies and procedures.
- High School Diploma or GED required.
- 1 year of health plan-based prior authorization experience.
HonorHealth offers a comprehensive benefits portfolio and opportunities for professional growth and development. If you are a detail-oriented and organized individual with excellent communication skills, we encourage you to apply for this exciting opportunity.
