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Job Requirements of Claims/ Authorization representative:
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Employment Type:
Full-Time
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Location:
McAllen, TX (Onsite)
Do you meet the requirements for this job?
Claims/ Authorization representative
Pyramid Consulting, Inc
McAllen, TX (Onsite)
Full-Time
Immediate need for a talented Claims/ Authorization representative. This is a 03+ Months Contract opportunity with long-term potential and is located in Texas (Remote). Please review the job description below and contact me ASAP if you are interested.
Job ID:25-65023
Pay Range: $17 - $18.50/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:
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, color, 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.
By applying to our jobs you agree to receive calls, AI-generated calls, text messages, or emails from Pyramid Consulting, Inc. and its affiliates, and contracted partners. Frequency varies for text messages. Message and data rates may apply. Carriers are not liable for delayed or undelivered messages. You can reply STOP to cancel and HELP for help. You can access our privacy policy .
#prof J2W:CB3
Job ID:25-65023
Pay Range: $17 - $18.50/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:
- Shift Timing: 8:00am – 5:00pm (subject to change depending on business needs) Possibly of over time according to business needs.
- The Centralized Authorization Team consists of the processing of authorizations for LTSS, in which we are now at a 3-4 BD TAT for the processing of LTSS/ SK/SH/MMP authorizations.
- We will utilize project temps/contingent workers to assist with each of these areas as well as cross train them to be able to assist in multiple functions.
- The authorization team continues to experience a high task and authorization volume as the number of VIP providers has increased.
- Outbound calls
- Data Entry
- Processing Authorization.
- Excellent attendance (especially during training)
- Daily goal will start with 5 authorizations for start then will move to 19 gradually
- Daily production trackers must be completed and emailed to designated person at the end of your shift
- Multi-tasking with multiple monitors and applications
- Utilize work guides and or resources
- 97% Quality (Audits)
- 98% Production
- 0-5% Error Rate
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Skills-Claims, Authorization, claims processing.
2+ years of medical experience in authorizations or claims processing practices in managed care setting. - Knowledge of customer service, medical terminology, and operation of office equipment.
- 2 years of medical experience in authorizations or claims processing practices in managed care setting.
- Knowledge of customer service, medical terminology, and operation of office equipment.
- Experience working remotely.
- High School Diploma or GED.
- Microsoft Outlook, Microsoft Word, Microsoft Excel, SharePoint, Internet, Microsoft Teams.
- Knowledge of customer service, medical terminology, and operation of office equipment.
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, color, 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.
By applying to our jobs you agree to receive calls, AI-generated calls, text messages, or emails from Pyramid Consulting, Inc. and its affiliates, and contracted partners. Frequency varies for text messages. Message and data rates may apply. Carriers are not liable for delayed or undelivered messages. You can reply STOP to cancel and HELP for help. You can access our privacy policy .
#prof J2W:CB3
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