Authorization Specialist I

Immediate need for a talented Authorization Specialist I. This is a 03+ months contract opportunity with long-term potential and is located in U.S(Remote; EST). Please review the job description below and contact me ASAP if you are interested.

Job ID: 25-82952

Pay Range: $20 - $21.73/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: Training M-F 8:30 AM-5 PM EST – 2 week course (No time off-CAMERAS ON)
  M-F 8:30 AM-5 PM EST (No OT)
• Computer Literacy assessment:
  https://hire.glider.ai/assess/63624421
• The out of network team reviews requests for out of network benefit coverage for preservice requests.
• The team is comprised of 9 nurses who perform participating provider searches as well as medical necessity reviews for services requested for our members, to be completed at out of network facilities or by out of network providers.
• Member and provider facing role.
• This is part of a project to determine Authorization specialist availability positions within the team and to support the out of network team during a time of high volume.
• This project will include administrative tasks associated with the administrative review of Participating provider searches for members within the client’s plans as well as support with data entry.
• The reviews will include phone calls (20-40 OUTGOING calls on daily basis) to participating providers to determine availability as well as placing calls to providers and members with the determinations.
• The team currently has productivity requirement of 1.2 cases per hour and quality of at least 95%.
• This is a new initiative, and the productivity is set in stone at this time.
• This is a new role within the team. The out of network team reviews many different types of requests, as opposed to one specific subtype, making our team’s cases extremely interesting.

Key Requirements and Technology Experience:  

• Key skills; Call center/Customer Service, Communication Skills & member outreach.  
• Requires a High School diploma or GED
• 2 years in medical call center setting, understanding of medical terminology and insurance preferred
• Unable to adhere to a fixed schedule. 
• Comfort with computers and multiple software applications at once / multitasking skills  
• Ability to speak on the phone with members and providers
• Attention to detail

 

Our client is a leading Healthcare Industry, and we are currently interviewing to fill this and other similar contract positions. If you are interested in this position, please apply online for immediate consideration.

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