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Prior Authorization Specialist

Remote • Posted 1 hour ago • Updated 1 hour ago

Contract W2

3 Months

Remote

Depends on Experience

Fitment

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Job Details

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Summary

Company Description
Lumen Solutions Group Inc. is a technology consulting Services Company based in Florida. We provide a 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, Enterprise Transformation.

Job Title: Prior Authorization Specialist
Location: 100% Remote (Must work EST hours)
Duration: 3-Month Contract

Position Summary
We are seeking a Utilization Management Coordinator to support the Utilization Management team with authorization processing, provider support, and administrative coordination activities. The ideal candidate will have experience in Utilization Management, healthcare operations, and a high-volume call center environment.

Key Responsibilities

Process incoming faxes and authorization requests.
Create, update, and maintain authorizations.
Handle inbound provider calls and resolve inquiries.
Support Utilization Management, care coordination, and utilization review activities.
Accurately document activities and maintain records in internal systems.
Collaborate with clinical and operational teams to ensure timely processing.

Required Qualifications

High School Diploma or equivalent.
3+ years of Utilization Management experience.
3+ years of experience in healthcare claims, provider services, customer service, or administrative support.
Previous call center experience in a high-volume environment.
Strong communication, organizational, and multitasking skills.

Preferred Qualifications

Experience with GuidingCare (strongly preferred).
Experience with Facets and NICE CXone.
Knowledge of CPT, ICD-10, and HCPCS codes.
Experience in a managed care or health insurance environment.

Lumen Solutions Group Inc is an equal opportunity employer. All qualified applicants will be considered for employment without regard to any legally protected status.

Employers have access to artificial intelligence language tools (“AI”) that help generate and enhance job descriptions and AI may have been used to create this description. The position description has been reviewed for accuracy and Dice believes it to correctly reflect the job opportunity.

Dice Id: 10483685
Position Id: 26-00432
Posted 1 hour ago

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