Prior Authorization Specialist

Detroit, Michigan

Employer: w3r Consulting
Industry: Administrative
Salary: Competitive
Job type: Part-Time
Remote position, but onsite required for training

Responsibilities:
  • Support providers and UM reviewers with prior authorization requests for post-acute care services. Includes manually entering authorization requests into Care Management systems, following rules and algorithms embedded in the care management system to administratively approve prior authorization requests
  • May work with providers to secure discharge plans, Notice of Non-Medical Coverage, Durable medical equipment, and other home supports required for discharge planning
  • May support scheduling physician to physician calls
  • Will support appeal processes for CMS designated Quality Improvement Organization appeals including logging all appeal activities

Qualifications:
  • High School Graduate or GED equivalent required
  • Two (2) years of college preferred
  • Two (2) years experience as medical assistant, care technician, post-acute care and home health care support staff or ancillary services in other health care related field preferred
  • Knowledge post-acute care functions and processes or discharge readiness activities may be preferred for some positions.
Created: 2024-08-30
Reference: 46858
Country: United States
State: Michigan
City: Detroit
ZIP: 48209

Similar jobs: