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Pre-Authorization Specialist - Remote in Multiple Locations
7 days agoWhat's your preference?
Job Description
- Req#: 2291137
Employer Industry: Healthcare Services
Why consider this job opportunity:
- Salary up to $33.22 per hour
- Comprehensive benefits package including equity stock purchase and 401k contribution
- Opportunity for career advancement and growth within the organization
- Flexibility to work remotely from Washington, Oregon, or California
- Supportive and inclusive work environment that values diversity
- On-the-job training provided to enhance skills and knowledge
What to Expect (Job Responsibilities):
- Initiate and manage referral authorizations, ensuring compliance with health plan requirements
- Provide administrative support and gather necessary information for processing referrals and authorization requests
- Act as a liaison between providers, clinical staff, patients, and health plans
- Review denied claims and assist in obtaining retro authorizations or appeals
- Maintain accurate documentation in electronic health records and ensure timely processing of referrals
What is Required (Qualifications):
- High School Diploma or GED
- Minimum of 2 years of experience in healthcare, with a focus on health plan operations
- Experience in referrals/pre-authorization management and claims billing
- Proficiency in Microsoft Outlook, Word, and Teams, as well as EHR/EMR systems (Epic)
- Ability to work full-time with flexibility for 8-hour shifts during business hours
How to Stand Out (Preferred Qualifications):
- 1+ years of experience specifically in referrals/pre-authorization management
- Experience in appeal writing and processing
- Familiarity with Explanation of Benefits (EOB), Coordination of Benefits (COB), and CMS 1500
- Knowledge of medical terminology, CPT & diagnosis coding, and basic anatomy
#HealthcareServices #RemoteWork #CareerGrowth #ComprehensiveBenefits #DiversityAndInclusion
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