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

Remote: 
Full Remote
Contract: 

Offer summary

Qualifications:

High School Diploma or GED required., 3 years of experience in health care claims/service areas or office support., Preferred: 2 years of experience in a health care/managed care setting., Knowledge of CPT and ICD-10 coding is a plus..

Key responsabilities:

  • Perform member or provider related administrative support including benefit verification and authorization management.
  • Review authorization requests for initial determination and triage for clinical review.
  • Provide general support and coordination services for the department, including answering calls and researching information.
  • Assist with reporting, data tracking, and organization of information related to Continuity of Care and Peer to Peer reviews.

Andeo Group LLC logo
Andeo Group LLC Human Resources, Staffing & Recruiting SME http://andeogroup.com/
11 - 50 Employees
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Job description

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

Industry :
Human Resources, Staffing & Recruiting
Spoken language(s):
English
Check out the description to know which languages are mandatory.

Other Skills

  • Communication
  • Problem Solving

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