Authorization Specialist I

Immediate need for a talented Authorization Specialist I. This is a 07 months contract opportunity with long-term potential and is located in California (Remote). Please review the job description below and contact me ASAP if you are interested.

Job ID: 25-79203

Pay Range: $20 - $21/hour. Employee benefits include, but are not limited to, health insurance (medical, dental, vision), 401(k) plan, and paid sick leave (depending on work location).

Key Responsibilities:

• 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.
• Understanding of medical terminology and insurance preferred.
• Supports authorization requests for services in accordance with the insurance prior authorization list
• Supports and performs data entry to maintain and update authorization requests into 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

Key Requirements and Technology Experience:

• Key Skills; Authorization Specialist, Utilization Review,Medicaid & Medical Backgroun and Insurance Verification
• Requires a High School diploma or GED
• Entry-level position typically requiring little or no previous experience.
• Medical background, authorization experience
• Medicaid experience, excel background.

Our client is a leading Healthcare Industry and we are currently interviewing to fill this and other similar contract positions. If you are interested in this position, please apply online for immediate consideration.

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