Prior Authorization Specialist Job at BroadPath, Remote

STZrdlh0Y2JKWGVyR0FLRXNDZWl5OFFiNUE9PQ==
  • BroadPath
  • Remote

Job Description

Overview:

BroadPath is hiring  Prior Authorization Specialist to work remotely from home. Our  Prior Authorization Specialist Responsible for reviewing and resolving authorization requests and communicating resolution to the appropriate parties in accordance with the standards and requirements established by the Centers for Medicare and Medicaid.  

Responsibilities:
  • Process authorization requests from intake for completeness and possible approval based on available criteria.
  • Research issues utilizing systems and other available resources.
  • Assures timeliness and appropriateness of requests according to state and federal and CareOregon Healthcare guidelines.
  • Approve/fund requests if available information aligns with criteria.
  • Route requests for clinical review as indicated.
  • Creates and/or maintains statistics and reporting.
Qualifications:
  • High school diploma or equivalent
  • 1 year of health claims experience, OR one year of customer service/provider service experience in a managed care or healthcare environment.
  • Ability to toggle through multiple systems
  • Strong verbal and written communication skills.
  • Processing Authorizations with Medicare Part C or D experience
  • Basic knowledge of medical terminology, computer literacy, and proficient keyboarding skills are required.
Diversity Statement:

At BroadPath, diversity is our strength. We embrace individuals from all backgrounds, experiences, and perspectives. We foster an inclusive environment where everyone feels valued and empowered. Join us and be part of a team that celebrates diversity and drives innovation!

Equal Employment Opportunity/Disability/Veterans  

If you need accommodation due to a disability, please email us at HR@Broad-path.com. This information will be held in confidence and used only to determine an appropriate accommodation for the application process  

 

BroadPath is an Equal Opportunity Employer. We do not discriminate against our applicants because of race, color, religion, sex (including gender identity, sexual orientation, and pregnancy), national origin, age, disability, veteran status, genetic information, or any other status protected by applicable law.  

 

Compensation: BroadPath has an effective process for assessing market data and establishing ranges to ensure we remain competitive. You are paid within the salary range based on your experience and market data of the position. The actual salary for this role may vary by location.  

Job Tags

Temporary work, Remote job, Work from home,

Similar Jobs

Johnson County Community College

Tutor II, Writing Center Job at Johnson County Community College

 ...Tutor II, Writing Center Job no: 497668 Work type: Part-time Temporary Location: Overland Park Main Campus Categories: Tutors and Lab Aides Position: Tutor II, Writing Center Department: Academic Affairs... 

Monadnock Community Hospital

Orthopedic Surgeon - Full Time Job at Monadnock Community Hospital

 ...Hospital, located in the beautiful Monadnock region of southern New Hampshire, is searching for a full-time community based Orthopedic Surgeon to join a highly regarded multispecialty group on the hospital's main campus. The Surgeon will join two established fellowship... 

Inno Supps

Customer Service Manager Job at Inno Supps

 ...Proven coaching and team development skills. ~ Strong communicator with conflict resolution expertise. ~ Proficient in Gorgias, Zendesk, Shopify, Recharge, WMS, or similar platforms. ~ Detail-oriented, organized, and data-driven. ~ Passion for health, wellness,... 

IntePros

Quality Control Supervisor Job at IntePros

 ...and performs quality control processes; executes sound quality policies to ensure safety and quality of products; and performs other...  ...control records to include equipment cleaning, maintenance, environmental monitoring, and supply inspections Assist with training of... 

Accordance Search Group

Clinical Education Specialist Job at Accordance Search Group

 ...Great opportunity for a Clinical Education Specialist with a disruptive start-up. This role will primarily support the development and execution of field-based training and education programs with procedural coverage and support. They will also work closely with marketing...