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

Addison Group

Senior Corporate Recruiter Job at Addison Group

 ...Job Title: Senior Recruiter Location: Cedar Rapids, Iowa Pay: $90,000 - $110,000 Benefits: This position is eligible for medical, dental, vision, 401(k), and parental leave Qualifications ~5+ years of full-cycle recruiting experience, including high-volume... 

Apex Systems

Business Analyst/UAT - LaserPro Job at Apex Systems

Apex Systems is currently hiring for a Business Analyst/UAT supporting LaserPro with a leading financial organization. The end goal of this initiative is to integrate LaserPro with nCino whereas currently, LaserPro is integrated with a different tool. This individual...

Guthrie

Patient Service Specialist-Pediatrics-Full Time Job at Guthrie

Position Summary: Monday - Friday its a rotating shift so the hours are between 730am - 4pm, 8am to 430pm, 830am - 5pm, 845am - 515pm, and a rotating Saturday from 8am to 12pm The Patient Service Specialist provides direct, daily operational front office support. ...

KISSINGER LEGAL SEARCH

Litigation Associate Attorney Job at KISSINGER LEGAL SEARCH

 ...Kissinger Legal Search is assisting a leading national law firm in its search for a talented 3rd 6th year Litigation Associate to join its Los Angeles office. About the Job: Join a law firm that not only values excellence, but also fosters an innovative, collegial... 

Proforma Physiotherapy and Performance

Travel Registered Dietitian Nutritionist - Paying up to $2,576/week Job at Proforma Physiotherapy and Performance

We are seeking a dedicated Travel Registered Dietitian Nutritionist (RDN) to provide specialized nutritional care in Syracuse, NY. Responsibilities include assessing patient nutritional needs, developing personalized care plans, and collaborating with healthcare teams...