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Important things YOU should know:
Fully Remote Opportunity! Work Schedule: Monday - Friday - 8:00am - 4:30pm Holiday/Wknd coverage required on a rotational basis. Currently approx. 4 times/year based on business need
What will YOU be doing for us? Have the opportunity to provide administrative support to the authorizations team including initial review of authorizations to ensure compliance and submission accuracy. What is in it for YOU?
What will YOU be working on?
Maintain accurate and detailed notes of work performed in the company system and in other appropriate documents/spreadsheets. Contact provider offices via phone and written communication to obtain missing clinical information needed in support of the pre-authorization determination process. Provide administrative support to team by performing various duties including but not limited to pulling information for audits, entering denial reasons and authorization schedules into internal systems, following up on non-clinical issues/requests. Modify authorizations as required/requested. Respond to questions from internal customers in a thorough and timely manner utilizing communication that is easily understood by others. Identify authorizations that require provider or member outreach in an effort to obtain additional information.
What qualifications do YOU need to have to be a GOOD candidate? Required Level of Education, Licenses, and/or Certifications
Required Level of Experience
Required Knowledge, Skills, and Abilities
Excellent Computer literacy including strong proficiency in Microsoft Office Excellent organizational skills to ensure required deadlines are met Demonstrated problem solving skills to allow for the correct diagnosis of a problem along with potential solutions for resolution Excellent communication skills
What qualifications do YOU need to have to be a GREAT candidate? Preferred Level of Education, Licenses, and/or Certifications
Preferred Level of Experience
Preferred Knowledge, Skills, and Abilities
Strong proficiency in Microsoft Office Suite Ability to quickly learn and incorporate new software into daily duties Excellent verbal and written skills Knowledge of Enterprise and/or Electronic Medical Record system Willingness to learn dental procedures, terminology and codes
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