Remote Jobs

Pre Authorization Specialist I


Pay$35984.00 / year
LocationSanta Clarita/California
Employment typeFull-Time
  • Job Description

      Req#: 616897
      Employer Industry: Medical Device Company

      Why consider this job opportunity:
      - Salary up to $61,152
      - Opportunity for career advancement and growth within the organization
      - Work remotely with a flexible remote work model
      - Supportive and collaborative work environment
      - Access to the latest tools, information, and training to advance your skills and career
      - Chance to make a meaningful difference in the health industry

      What to Expect (Job Responsibilities):
      - Answer incoming calls received through the Pre-Authorization Support ACD and provide appropriate call/case handling
      - Perform benefit verification and pre-surgical authorization for new pre-surgical cases, and manage appeals by collaborating with payers
      - Review payer denials and determine appropriate next steps according to payer appeal guidelines
      - Utilize Microsoft Office and database management to document case status, actions, and outcomes
      - Communicate and build relationships with healthcare professional offices and sales representatives regarding inquiries and case handling

      What is Required (Qualifications):
      - High School Diploma or equivalent
      - Minimum 2 years of experience authorizing medical procedures/surgeries with commercial, Medicare, and worker's comp payers (pain management/spine preferred)
      - Minimum 1 year of claim appeal experience
      - Secure home office space with the ability to protect HIPAA sensitive materials
      - Reliable high-speed internet connection

      How to Stand Out (Preferred Qualifications):
      - Experience in a call center environment
      - Knowledge of healthcare insurance processes and payer systems
      - Strong customer service skills
      - Familiarity with medical terminology related to pain management and spine procedures
      - Ability to suggest continuous process improvements

      #MedicalDevice #RemoteWork #HealthcareCareers #CareerGrowth #CustomerService

      "We prioritize candidate privacy and champion equal-opportunity employment. Central to our mission is our partnership with companies that share this commitment. We aim to foster a fair, transparent, and secure hiring environment for all. If you encounter any employer not adhering to these principles, please bring it to our attention immediately. We are not the EOR (Employer of Record) for this position. Our role in this specific opportunity is to connect outstanding candidates with a top-tier employer."
  • About the company

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