[Hiring] Prior Authorization Specialist @Alpine Physician Partners
This description is a summary of our understanding of the job description. Click on 'Apply' button to find out more.
Role Description
This role involves evaluating referral and pre-certification requests in accordance with contractual obligations and regularly interacting with physician offices to assist with prior authorizations.
ā¢ Communicates well both verbally and in writing
ā¢ Creates accurate and punctual reports
ā¢ Delivers presentations and shares information and ideas with others
ā¢ Develops and maintains good working relationships with team members, other departments, medical directors, and provider offices
ā¢ Breaks down problems into smaller components and understands underlying issues
ā¢ Answers phones regarding questions related to prior authorization
ā¢ Manages a fair workload and volunteers for additional work
ā¢ Follows documented processes to review healthcare service requests
ā¢ Seeks out and accepts feedback, is a proactive learner
ā¢ Builds customer confidence and is committed to increasing customer satisfaction
ā¢ Participates as part of the Prior Authorization team by actively interacting with other team members
ā¢ Evaluates referral and pre-certification requests to determine eligibility and network affiliation
Qualifications
ā¢ High School diploma/GED; MA or Associates degree highly preferred
ā¢ One to three years healthcare experience required (medical office, healthplan, etc.)
ā¢ One to three years utilization management experience highly preferred
ā¢ Knowledge of medical terminology required
ā¢ Knowledge of medical coding, NCQA and Medicare Guidelines required
ā¢ Proven customer service skills required
ā¢ Excellent written and verbal communications skills required
ā¢ Skilled in computer competency using Microsoft Outlook, Word and Excel
ā¢ Ability to work in a windows based environment utilizing numerous programs at once
ā¢ Ability to work in a fast-paced environment
ā¢ Ability to identify and solve practical problems
ā¢ Ability to maintain positive and effective work relationships with coworkers, clients, members, and providers
ā¢ Strong organizational skills
ā¢ Strong attention to detail
ā¢ Home office that is HIPAA compliant for all remote or telecommuting positions as outlined by the company policies and procedures
Requirements
ā¢ Salary Range: $19.71 - $26.28
Apply Now
Apply Now
Role Description
This role involves evaluating referral and pre-certification requests in accordance with contractual obligations and regularly interacting with physician offices to assist with prior authorizations.
ā¢ Communicates well both verbally and in writing
ā¢ Creates accurate and punctual reports
ā¢ Delivers presentations and shares information and ideas with others
ā¢ Develops and maintains good working relationships with team members, other departments, medical directors, and provider offices
ā¢ Breaks down problems into smaller components and understands underlying issues
ā¢ Answers phones regarding questions related to prior authorization
ā¢ Manages a fair workload and volunteers for additional work
ā¢ Follows documented processes to review healthcare service requests
ā¢ Seeks out and accepts feedback, is a proactive learner
ā¢ Builds customer confidence and is committed to increasing customer satisfaction
ā¢ Participates as part of the Prior Authorization team by actively interacting with other team members
ā¢ Evaluates referral and pre-certification requests to determine eligibility and network affiliation
Qualifications
ā¢ High School diploma/GED; MA or Associates degree highly preferred
ā¢ One to three years healthcare experience required (medical office, healthplan, etc.)
ā¢ One to three years utilization management experience highly preferred
ā¢ Knowledge of medical terminology required
ā¢ Knowledge of medical coding, NCQA and Medicare Guidelines required
ā¢ Proven customer service skills required
ā¢ Excellent written and verbal communications skills required
ā¢ Skilled in computer competency using Microsoft Outlook, Word and Excel
ā¢ Ability to work in a windows based environment utilizing numerous programs at once
ā¢ Ability to work in a fast-paced environment
ā¢ Ability to identify and solve practical problems
ā¢ Ability to maintain positive and effective work relationships with coworkers, clients, members, and providers
ā¢ Strong organizational skills
ā¢ Strong attention to detail
ā¢ Home office that is HIPAA compliant for all remote or telecommuting positions as outlined by the company policies and procedures
Requirements
ā¢ Salary Range: $19.71 - $26.28
Apply Now
Apply Now