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

Advanced Environmental Laboratories, Inc.

Environmental Laboratory Analyst Job at Advanced Environmental Laboratories, Inc.

About AEL: Advanced Environmental Laboratories, Inc. (AEL) is Florida's largest environmental, chemical, analytical testing laboratory network. AEL has been in business for over 30 years and is a leader in the industry with modern instrumentation, computer technology,...

The Demarco Group

Associate Broker Job at The Demarco Group

 ...Fully Remote- Seeking a licensed Executive Lines remote SR Inside Broker/AE for a top wholesale broker operation in the country. This role is heavier in D&O, crime, fiduciary, EPL but also has cyber and E&O. The Inside Broker/AE is responsible for assisting the... 

James W. Fowler Company

Project Engineer Job at James W. Fowler Company

not open to recruitment agencies. Specific Responsibilities This position will be responsible for assisting the project team in the successful completion of the project. The following responsibilities are intended to describe the general nature and level of work performed...

Aptino, Inc.

Graduated / Newcomer / Entry-level / CSR / New hire / College graduate / Junior / Trainee / Intern / Internship / Customer Care / Internship / Customer Service / Admin Job at Aptino, Inc.

Role: Customer Care Representative Location: Plano, TX Job Type: Full Time + Hybrid Job Job Description: Our Customer Experience team plays a critical role in identifying pain points, solving issues, and continuously improving the customer journey . ...

BakeMark

Operations Manager Job at BakeMark

 ...partnerships within the company and with our loyal customers. We love to innovate and thrive to manufacture and deliver performing bakery products and world-class customer service. With over 100 years of service to the baking industry, BakeMark is recognized as an industry...