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Pre-Authorization Specialist

Diverse Lynx

Role overview

Qualifications

  • 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

Responsibilities

  • Meet production, quality and regulatory expectations
  • Ensure case is set up correctly and document required information
  • Review, research and determine if case can be decisioned or if it requires additional clinical review
  • Make outbound calls to providers and/or members as needed

Key facts

  • Remote from: Anywhere
  • Full time
  • Junior (1-2 years)
  • English

Hard skills

Office Management Health Administration ICD 503 CPT Coding Medicare Medicaid Medical Software Organizational Structure

Other skills

  • Decision Making
  • Problem Solving
  • Customer Service
  • Microsoft Office
  • Communication
  • Critical Thinking
  • Prioritization
  • Detail Oriented
  • Teamwork

About the company

Diverse Lynx logo

Diverse Lynx

IT Services & IT Consulting

We are a WBENC and NMSDC certified company helping our clients in their Diversity spending on Staffing or Contingent Workforce Services. Established in 2002 and headquartered out of Princeton-NJ, our 2000+ associates’ strength globally helps clients with talent across Technology, Healthcare, Life Sciences, Aerospace, Automotive, Energy, Pharmaceuticals, Retail, Telecom, Manufacturing and Engineering domains. Our presence in USA, Canada & India helps us support clients in IT, Non-IT, Healthcare, Hospital and Clinical hiring, across the globe.

Company details

Company typeLarge
IndustryIT Services & IT Consulting
Company size1001 - 5000

Links

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Job description

Job Title: Pre-Authorization Specialist
Location: Remote
Duration: Full Time
Salary: $17/hr. + Benefits

Note- This is a combined call/back-office role. Candidates need to be comfortable with handling calls.

Schedule in operations : Candidates only who are willing to work Monday- Sunday- Operational hours : 7 am CST- 7 pm CST

Training Schedule-M- F 9:30 am - 6 pm CST.


Primary Responsibilities:
  • This is a production role and you will have the responsibility to meet production, quality and regulatory expectations
  • Ensure case is set up correctly and document required information
  • Review, research and determine if case can be decisioned 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 manager and/or director

Qualifications
Required:
  • 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 7am-7pm; Tuesday-Saturday or Sunday-Thursday shifts may be available
  • Flexibility to work outside standard hours of operations due to changing business needs
  • Ability to trouble shoot and setup computer equipment independently

Preferred:
  • 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

Soft Skills:
  • Strong communication skills; Written and verbal
  • Excellent critical thinking and problem - solving skills
  • Candidate needs to be highly organized
  • Analytical, problem solving and decision-making skills; ability to exercise good judgment
  • Ability to prioritize 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






Diverse Lynx LLC is an Equal Employment Opportunity employer. All qualified applicants will receive due consideration for employment without any discrimination. All applicants will be evaluated solely on the basis of their ability, competence and their proven capability to perform the functions outlined in the corresponding role. We promote and support a diverse workforce across all levels in the company.

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MR

Marcus Rivera

Chief Revenue Officer

m.rivera@company.com
linkedin.com/in/marcusrivera
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