Lavori attuali relativi a Businessoperations - Authorization Specialist I - J00903 - Lazio - Altro
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Businessoperations - Authorization Specialist I - J00903
3 settimane fa
Position Purpose Supports the prior authorization request to ensure all authorization requests are addressed properly and in the contractual timeline.Aids utilization management team to document authorization requests and obtain accurate and timely documentation for services related to the members' healthcare eligibility and access.Education & ExperienceRequires a High School diploma or GED.Entry-level position typically requiring little or no previous experience.Understanding of medical terminology and insurance preferred.ResponsibilitiesSupports authorization requests for services in accordance with the insurance prior authorization list.Supports and performs data entry to maintain and update authorization requests in the utilization management system.Assists utilization management team with ongoing tracking and appropriate documentation on authorizations and referrals in accordance with policies and guidelines.Contributes to the authorization review process by documenting necessary medical information such as history, diagnosis, and prognosis based on the referral to the clinical reviewer for determination.Remains up-to-date on healthcare, authorization processes, policies and procedures.Performs other duties as assigned.Complies with all policies and standards.Typical Day in the RoleAnswer intake calls from providers and process authorizations received via fax through the Filenet portal.Build authorizations, task to clinical team timely, and document efforts in TruCare.Meet phone service levels >95% daily and complete around 35 authorization builds per day.Maintain audit scores >95% each month.Candidate RequirementsMinimum 1–2 years of related experience (intake, insurance, prior auth, utilization management, experience within foster care).High school diploma or GED required; preference for licensure in healthcare administration or other relevant credentials.Ability to handle high-volume intake calls and process authorizations via fax and portal.Strong organization, prioritization, and multitasking skills.Excellent verbal and written communication with providers and team.Ability to work independently and meet timely deadlines.Disqualifiers: only call-center experience (without related experience), fostering-related constraints requiring compliance.EEO StatementMindlance is an Equal Opportunity Employer and does not discriminate in employment on the basis of – Minority/Gender/Disability/Religion/LGBTQI/Age/Veterans.#J-*****-Ljbffr
