Prior Authorization Specialist

As aPre-AuthConsultantyou will be a part of an Agile team to build healthcare applications and implement new features while adhering to the best coding development standards . Mandatory skills FACETS UM/Pre-Auth Configuration ITS/Authorization Routing Logic SQL & Rule Traceability Responsibilities: - 7 - 10 years in UM/Pre-Auth configuration within FACETS. Familiarity with UM workflows, clinical guidelines, and state mandates. Experience working with clinical/utilization management stakeho

Lead Product Owner / Business Integration Lead (Prior Authorization) Location/Work model:100% Remote (must workEastern Time core hours) Type:Contract (~7 months, Possible extension) Compensation: $72/HRAbout the role Were looking for aLead Product Owner / Business Integration Leadto stabilize and improveend-to-end Prior Authorization (PA)operations and the supporting technology/process integrations. This is atrue hybrid role(Product Owner + Business Integration Lead) focused on fixing real break

Seeking a Healthcare focused, Utilization Management Coordinator, to support the Utilization Management clinical teams by assisting with non-clinical administrative tasks and responsibilities related to pre-service, utilization review, care coordination and quality of care. ESSENTIAL FUNCTIONS: - 35% Performs member or provider related administrative support which may include benefit verification, authorization creation and management, claims inquiries and case documentation. - 35% Reviews auth

Company Description Lumen SolutionsGroupInc. is a technology consulting Services Company based inFlorida. Weprovidea wide array of experienced business and IT professionals supporting clients from solution design to implementation and support.We specialize in professional IT consulting services, IT Staffing, Business/IT Strategy, Business Process Blueprints, Enterprise Architecture, EnterpriseTransformation. Job Title: Prior Authorization Specialist Location: 100% Remote (Must work EST hours) D