Prior Authorization Coordinator - Remote

Overview

The Prior Authorization Coordinator is responsible for handling and tracking medical necessity review requests for a growing third-party administrator of self-funded employee benefit plans.

In Short

• Full-time position.
• Handle and track medical necessity review requests.
• Review plan document language for service eligibility.
• Forward documentation for medical necessity review.
• Draft and send response letters based on vendor determinations.
• Track medical necessity reviews using internal systems and vendor portals.
• Run and review various reports.
• Assist with department inquiries.
• Review Single Case Agreement requests.
• Work in a remote environment.

Requirements

• Understanding of medical terminology.
• Familiarity with ICD10 and HCPCS/CPT codes.
• 1+ year medical experience preferred.
• 1+ year data entry experience and QicLink experience.
• Proficient PC skills including email and record keeping.
• Experience in a professional office environment.
• High school diploma with 1-2 years related experience or equivalent.

Benefits

• Medical, Dental, Vision coverage.
• Flexible Spending Account.
• Gym Membership Reimbursement.
• Life Insurance.
• Long-Term and Short-Term Disability.
• 401K plan.
• 3 weeks vacation.
• 9 paid holidays.
• Casual dress code.