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

Search Services

Senior Network Engineer Job at Search Services

ABOUT OF CLIENT Join Our Client as a Senior Network Engineer and lead the design, security, and optimization of enterprise network infrastructure. Bring your expertise in Cisco, SD-WAN, and cloud environments to drive innovation and reliability across global systems. ...

Vivid Resourcing

Marketing Manager Job at Vivid Resourcing

 ...Overview: We are seeking an experienced Marketing Manager to lead strategic marketing initiatives within our healthcare and specialty operations. This individual will develop, implement, and oversee marketing campaigns to promote our products and services, driving... 

LocumTenens.com

Compliance Analyst - Regulatory Job at LocumTenens.com

 ...The Compliance Analyst - Regulatory will be responsible for providing specialized support to the Legal team in the area of statutory and regulatory requirements impacting the locum tenens industry. More specifically, this position will primarily be responsible for conducting... 

CivicMinds, Inc

Social Worker Job at CivicMinds, Inc

 ...addiction to community agencies for treatment. # Networks with local social service agencies and educational agencies to remain...  ...community health setting. # Experience working with youth and adult populations. # Licensed Social Worker in the state of Ohio... 

Scott Humphrey Corporation

Senior Estimator - Multifamily Construction Job at Scott Humphrey Corporation

Job description A top Florida GC is looking to add an estimator to their team. Specializing in Wood-Frame garden styles and concrete mid-rises, they are looking for an experienced estimator in Tampa to work on their pipeline. What's on Offer: Competitive base ...