Prior Authorization Coordinator

Vaga não está no LinkedIn

🕒 Junho 24

🇺🇸 Estados Unidos – Remoto (EUA)

💵 $19 - $21 / hora

⏰ Tempo Integral

🟢 Júnior

🚫👨‍🎓 Sem graduação necessária

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Point Health

SiteLinkedInTodas as Vagas

1 - 10 funcionários

💼 Consultoria

🛡️ Seguros

📣 Marketing

Consulting • Insurance • Marketing

A Point Health é uma empresa de saúde que se especializa em fornecer soluções de tratamento para o manejo de dores crônicas. Eles colaboram com médicos e clínicas de alta qualidade para oferecer consultas para o dia seguinte, facilitando o acesso dos pacientes aos cuidados necessários. Aproveitando uma abordagem multidisciplinar, a Point Health visa fornecer estratégias eficazes de gestão da dor, garantindo uma experiência tranquila para os pacientes, incluindo a opção de avaliações de seguro e tempos mínimos de espera.

Descrição

• Manage the entire authorization process for interventional pain management procedures • Monitor advanced procedure trackers for each practice to identify authorization opportunities • Collect all required documentation for prior authorizations • Review medical necessity guidelines for procedures by Paycor • Accurately and promptly submit prior and retro authorization requests to payors • Document account activity, updating patient and claim information to ensure efficient claim processing • Identify trends or issues that delay authorization or claims processing • Communicate with practices, vendors, insurance companies, patients, and management to secure necessary approvals • Provide the highest level of customer service to internal teams • Serve as a backup to the Contact Center Team during peak scheduling call times • Perform other related duties as assigned to support smooth operations and patient care continuity

🎯 Requisitos

• High School Diploma or GED (required) • Minimum of 1 year of prior authorization and clinical setting experience (required) • Experience working within Pain Management required • Proficient in Microsoft Office Suite • Strong analytical and problem-solving abilities • Excellent organizational skills and attention to detail • Knowledge of HIPAA privacy and security requirements • Basic understanding of medical terminology • Familiarity with payor portals and medical policy navigation • Must be able to sit for extended periods, communicate clearly, perform computer-based tasks, occasionally lift up to 25 lbs, and maintain close vision, depth perception, and focus adjustment.

🏖️ Benefícios

• Health, Dental & Vision Insurance • Accident and Life/AD&D Insurance • Short & Long-Term Disability • Emergency Travel Assistance Program • ID-theft Protection Services • LifeMart Employee Discount Program • Health Savings Account (HSA) • Health Management Tools • Paid Time Off (PTO) • Company Paid Holidays • Paternal Leave • 401(k) Retirement Plan • Remote Stipend • Travel Reimbursement • Continuing Education Reimbursement • Bonusly (employee recognition platform) • DailyPay (on-demand pay access)