Immediate need for a talented Pre- Authorization Specialist. This is a Fulltime opportunity with long-term potential and is located in Atlanta, GA(Onsite). Please review the job description below and contact me ASAP if you are interested.
Job ID:25-94939
Pay Range: $16 - $17/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:
- This is a production role, and you will have the responsibility to meet production, quality and regulatory expectations
- Ensure the case is set up correctly and document the required information
- Review, research and determine if the case can be decided or if it requires additional clinical review
- Demonstrate proficiency and decision-making by solving complex problems using available resources (documents,medical policy, standard operating procedure, etc.)
- As needed, make outbound calls to providers and/or members to obtain information regarding a case.
- As needed, make outbound calls to providers to coordinate provider availability in treating members. Other duties as assigned by the manager and/or director .
Key Requirements and Technology Experience:
- Key Skills; Strong communication skills; Written and verbal
- Excellent critical thinking and problem-solving skills
- The candidate needs to be highly organised
- Analytical, problem-solving solving and decision-making skills; ability to exercise good judgment
- Ability to prioritise work, handle multiple tasks and work independently
- Ability to focus and learn in a remote setting as an independent contributor
- Strong attention to detail and maintaining quality focus, and multi-tasking
- Team oriented
- Minimum of a High School Diploma / GED
- 1 years of professional experience in an office or healthcare environment
- Prior customer service experience making outbound calls
- Proficiency in using a computer
- Experience working with Microsoft Office Products, including Microsoft Outlook (ability to create, edit, save, and send emails), Microsoft Word (ability to create, edit, save, and send documents), and Microsoft Excel (ability to create, edit, save, and send spreadsheets).
- Ability to work an eight (8) hour shift Monday-Friday between 7 am-7 pm; Tuesday-Saturday or Sunday-Thursday shifts may be available
- Flexibility to work outside standard hours of operation due to changing business needs
- Ability to troubleshoot and set up computer equipment independently
- Must have a designated work area established that is separate from other living areas and can be secured to maintain PHI or PI security in line with Group policies and standards
- Must work at a designated approved UnitedHealth Group office or live in a location that can receive a dedicated hardwired high-speed internet connection or leverage an existing high-speed internet service provider (ISP) (minimum speed 1.5 download Mbps and 1 upload Mbps).
- In areas where a UnitedHealth Group-approved ISP is not available, manager approval to leverage a local ISP and receive reimbursement for business utilization is required and available on an exception basis only.
- Previous experience working with back office medical platforms and/or authorizations systems
- Experience working within the Healthcare Industry, Hospital, Physician's Office, or Medical Clinical setting, Medical
- Terminology, ICD-10 and CPT codes, Medicare and/or Medicaid Services
- Professional experience in a Clerical or Administrative support-related role
- Able to quickly learn various computer systems or applications
Our client is a leading IT 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.
Pyramid Consulting, Inc. provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, colour, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.
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