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

Beacon Health System

Clinical Informatics Specialist Job at Beacon Health System

 ...the development, testing, implementation, and training of Beacon Health Systems clinical information systems. Key...  ...needs into system solutions. Training & Support : Provide education, training, and ongoing support to physicians, nurses, and staff... 

Millman Search

Service Writer Job at Millman Search

Ever consider joining the exciting "WORLD of BOATING!?" Baltimore-area based Boat Dealer/Marina has opening for a Service Writer/Advisor this is a full-time, permanent position, (some overtime during boating season) with no off-season layoff. The SA/W will perform write...

Virtus Health, LLC

Board Certified Behavior Analyst (BCBA) Job at Virtus Health, LLC

 ...Job description: Are you a Board Certified Behavior Analyst (BCBA) who is passionate about making a difference in a childs life every day? Virtus Health has the position and career path for you! Due to our continued growth, we have two BCBA positions available at... 

Dexian

Construction Health and Safety Manager Job at Dexian

&##128269; We're Hiring: Construction Health and Safety Manager Hyperscale Data Centers Are you a seasoned safety professional with a passion for driving excellence in high-risk construction environments? Do you have experience working with major data center players... 

Aimic Inc

Call Center Representative Job at Aimic Inc

 ...Job Title: Call Center Representative Pay Rate: $23.84 per hour Number of Positions: 18 (all open) Location: San Diego, CA Training...  ...followed by 12 weeks onsite or remote. Possible remote work option available after training and successful assessments...