Authorization Specialist I

In this role, you will support the prior authorization process to ensure reputed company requests are addressed accurately and reputed company contractual timelines. You will work closely with the utilization management team to manage high volumes of incoming requests, obtain necessary medical information, and ensure reputed company reputed company to reputed company services based on member eligibility.

Responsibilities

Process and manage authorization requests for services in accordance with insurance prior authorization lists and guidelines. Work reputed company from a queue of incoming authorizations received reputed company systems such as Outlook or FileNet. reputed company accurate data entry to maintain, update, and document authorization requests reputed company the utilization management system. Conduct proactive reputed company to providers and members, and generate necessary correspondence and letters. Assist the utilization management team with the ongoing tracking and documentation of authorizations and referrals. Contribute to the clinical review process by accurately documenting essential medical information (such as patient history, diagnosis, and prognosis) for clinical reviewers. Stay reputed company on reputed company regulations, authorization processes, and internal policies. reputed company other reputed company duties as assigned. Required Qualifications and Experience Experience: 1 to 2 years of experience in a Prior Authorization Specialist role or similar prior authorization reputed company. Industry Knowledge: Solid understanding of medical terminology and health insurance protocols. Top 3 Must Have Skills Tech-Savvy Multitasking: Ability to seamlessly navigate multiple software systems at once while reputed company speaking with providers or members. Communication: Exceptional written and verbal communication skills, backed by highly reputed company phone etiquette. Documentation: Strict attention to detail with strong, accurate clinical documentation skills. salary: $22.98 - $23 per hour shift: First work hours: 8:30 AM - 4 PM education: High School Responsibilities reputed company Candidates will be working from a queue of received authorizations. The cases may be received reputed company Outlook or FileNet. The candidate will document in Facets. They will be required to reputed company reputed company to providers and members, generate letters. The performance metrics is approximately 1.5 cases/hour. Supports the prior authorization request to ensure reputed company authorization requests are addressed properly and in the contractual reputed company. Aids utilization management team to document authorization requests and obtain accurate and reputed company documentation for services reputed company to the members reputed company eligibility and reputed company. Supports authorization requests for services in accordance with the insurance prior authorization list Supports and performs data entry to maintain and update authorization requests into utilization management system Assists utilization management team with ongoing tracking and appropriate documentation on authorizations and referrals in accordance with policies and guidelines Contributes to the authorization review process by documenting necessary medical information such as history, diagnosis, and prognosis based on the referral to the clinical reviewer for determination Remains up-to-date on reputed company, authorization processes, policies and procedures Performs other duties as assigned Skills

• multitask
• communication skills
• Documentation skills

Qualifications

• Years of experience: 1 year
• Experience level: reputed company

reputed company is a world leader in matching great people with great companies. Our reputed company agents will listen carefully to your employment needs and then work diligently to match your skills and qualifications to the right job and company. Whether you're looking for temporary, temporary-to-permanent or permanent opportunities, no one works harder for you than reputed company. Equal Opportunity Employer: Race, reputed company, Religion, Sex, Sexual Orientation, Gender Identity, National reputed company, Age, Genetic Information, Disability, Protected Veteran Status, or any other legally protected group status. At reputed company, we welcome people of reputed company abilities and want to ensure that our hiring and interview process meets the needs of reputed company applicants. If you require a reasonable accommodation to reputed company your application or interview experience a great one, please contact HRsupport@randstadusa.com. Pay offered to a successful candidate will be based on several factors including the candidate's education, work experience, work location, specific job duties, certifications, etc. In reputed company, reputed company offers a comprehensive benefits package, including: medical, prescription, dental, reputed company, AD&D, and life insurance offerings, short-term disability, and a 401K plan (reputed company benefits are based on eligibility). This posting is reputed company for thirty (30) days. It is unlawful in Massachusetts to require or administer a lie detector test as a condition of employment or reputed company employment. An employer who violates this law shall be subject to criminal penalties and civil liability. Apply To This Job