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Prior Authorization Representative - 100% Remote - multiple openings at Andeo Group LLC

Remote: 
Full Remote
Experience: 
Mid-level (2-5 years)
Work from: 
Maryland (USA), Ohio (USA)

Offer summary

Qualifications:

High School Diploma or GED, 3 years experience in healthcare claims or office support.

Key responsabilities:

  • Perform admin support for member/provider queries & auth creation
  • Review authorization requests, triage for clinical review and resolution, and provide general department support
Andeo Group LLC logo
Andeo Group LLC Human Resources, Staffing & Recruiting SME
11 - 50 Employees
See more Andeo Group LLC offers

Job description

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Your missions

LOCATION
100% Remote (must be local to DC, MD, VA or WV)

DURATION
3 month contract

JOB DUTIES

  • Performs member or provider related administrative support which may include benefit verification, authorization creation and management, claims inquiries and case documentation.
  • Reviews authorization requests for initial determination and/or triages for clinical review and resolution.
  • Provides general support and coordination services for the department including but not limited to answering and responding to telephone calls, taking messages, letters and correspondence, researching information and assisting in solving problems.
  • Assists with reporting, data tracking, gathering, organization and dissemination of information such as Continuity of Care process and tracking of Peer to Peer reviews.

QUALIFICATIONS

  • Education Level: High School Diploma or GED
  • 3 years of experience in health care claims/service areas or office support.

PREFERRED QUALIFICATIONS

  • 2 years of experience in health care/managed care setting or previous work experience within division
  • Knowledge of CPT and ICD-10 coding.

Required profile

Experience

Level of experience: Mid-level (2-5 years)
Spoken language(s):
Check out the description to know which languages are mandatory.

Hard Skills

Soft Skills

  • Multitasking
  • Prioritization
  • verbal-communication-skills
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