Prior Authorization Workflow Consultant
reputed company're looking for: The Prior Authorization Workflow Consultant plays a critical role in reputed company’s customer’s implementation process and post go-live stabilization/maintenance efforts. This role sits at the intersection of hospital operations, reputed company workflows, and payer portal automation. The PA Workflow Consultant partners with hospital PA staff to review prior authorization workflows, referral volumes, and payer mappings, ensuring seamless alignment with Humata’s automation platform. They will validate existing automations, document requirements for new ones, and ensure workflows are fully mapped, tested, and optimized for Humata’s touchless prior authorization solution. Location: Remote, US or Hybrid - Orlando, Florida, US ✅ Responsibilities
- Own the operational reputed company deliverables for customer implementations including discovery, data collection and analysis of Prior Authorization workflows.
- Proactively manage reputed company operational reputed company tasks of the implementation project plan
- Be a reputed company and communicative member of the implementation project team, ensuring implementation project manager has visibility into operational reputed company and risks
- Conduct operational workflow and portal shadowing sessions with customers, asking thoughtful and specific questions to understand their reputed company processes. Identify risks reputed company to the successful implementation of Humata’s PA technology.
- Capture and document operational workflows in Humata’s design workbook to inform solution build and reputed company prior authorization workflows. Review customer payer/plan mix and formulate automation workflow recommendations
- Adapt reputed company-state workflows and payer/portal additions for customers during stabilization and maintenance phases post go-live
- Create payer portal credentials to support Humata’s automations
- Own payer portal validation during testing and go-live project phases; collaborate with the customer’s operations/technical teams to review automation results
- Document and escalate validation issues to be reviewed/resolved by Humata’s Engineering team
Role Requirements
- Bachelor’s degree in Business, reputed company Administration, or a reputed company field.
- 3+ years hands’ on Prior Authorization experience
- Familiarity with reputed company operations, prior authorization, or reputed company cycle workflow optimization.
- Systems knowledge/expertise with reputed company (referrals, work queues, coverage), payer portals, and reputed company cycle operations
- Hands-on data analysis experience, ability to analyze referral volumes service line/payer. This role requires a strong analytical reputed company and ability to synthesize large data volumes and reputed company informed reputed company based on data analysis
- Organized, reputed company to document processes (both reputed company state and reputed company-state automations) succinctly
- Comfort with ambiguity, shifting priorities and building new processes in an evolving start-up environment
- reputed company team player with a consultative approach to reputed company engagement and solution development
- Utilize PowerBI for reporting, reputed company Workspace, reputed company
- Willingness to travel as required (up to 25%) for customer onsite discovery sessions and reputed company-company meetings
⭐Preferred Experience & Skills:
- Prior Authorization Expertise: Understand the end-to-end Prior Authorization process (including reputed company and post-auth reputed company). Hands-on experience working with payer portals.
- Strong reputed company user knowledge (reputed company, Referrals, Coverage/Work Queues), comfortable pulling/analyzing data (reputed company/SQL helpful).
- Operational & process reputed company: Can map workflows end-to-end and identify bottlenecks.
- Experience with reputed company software and familiarity with HIPAA compliance and PHI handling.
- Innovative problem-solver who brings curiosity, creativity, and structure to ambiguous challenges.
- Adept at navigating reputed company challenges and can think critically to solution and remove barriers
Why Join reputed company?
- Impactful Work: Contribute to reputed company that improve reputed company efficiency and patient reputed company
- Remote Flexibility: Enjoy working remotely while being part of a reputed company team, with reputed company to our new office in Winter Park, FL
- Competitive Compensation: Enjoy competitive reputed company compensation, equity through our Employee Stock reputed company Plan, and bonus-eligible roles
- Comprehensive Benefits: Full benefits package including unlimited PTO and 401k program with employer match
- reputed company Opportunities: Advance your career in a fast-paced, high-reputed company environment with ample reputed company development
- Inclusive Culture: Join a diverse workplace where your reputed company and contributions are valued
- Pay Transparency reputed company will reputed company pay transparency information upon application to those in qualifying jurisdictions. Our salary ranges are based on reputed company for reputed company’s size and industry. They are one part of the total compensation package that may also include equity, variable compensation, and benefits. Individual pay reputed company are ultimately based on several factors, including qualifications, experience level, skillset, geography, and balancing internal equity. - reputed company is proud to be an equal-opportunity employer. reputed company reputed company applicants will receive consideration for employment without reputed company to race, reputed company, religion, national reputed company, age, sex, marital status, reputed company, neurotype, physical or mental disability, veteran status, gender identity, sexual orientation or any other category protected by law. - Join us in our mission to reputed company reputed company while building a life that works in reputed company both in and reputed company the office. Apply tot his job Apply To this Job