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    Authorization Specialist I - Dallas, United States - TEKsystems

    TEKsystems
    TEKsystems Dallas, United States

    1 week ago

    Default job background
    Description
    Hiring For Medical Coordinator

    100% REMOTE

    Note:
    Candidates from Texas can only apply

    Candidates who are having 2+yrs of experience in Medical field can only apply


    Description:

    Position Purpose:
    Supports the prior authorization request to ensure all authorization requests are addressed properly and in the contractual timeline.

    Aids utilization management team to document authorization requests and obtain accurate and timely documentation for services related to the members healthcare eligibility and access.

    Walk me through the day-to-day responsibilities of this the role and a description of the project (Outside of Workday JD):


    • Receive incoming medical authorization requests from hospitals via E-fax, phone queue, or web
    • Date enter authorization request and transmit back to facility via E-fax or phone
    Describe the performance expectations/metrics for this individual and their team:


    • Referral Specialist are required to enter five minimum of five structured notes per hour
    Tell me about what their first day looks like:


    • There will be a phone call from me as an introduction and consist E-trainings with my guidance via Centene University
    Understanding of medical terminology and insurance preferred.

    Supports authorization requests for services in accordance with the insurance prior authorization list

    Responsibilities:
    Supports and performs data entry to maintain and update authorization requests into utilization management system


    Assists utilization management team with ongoing tracking and appropriate documentation on authorizations and referrals in accordance with policies and guidelines.


    Contributes to the authorization review process by documenting necessary medical information such as history, diagnosis, and prognosis based on the referral to the clinical reviewer for determination.

    Remains up-to-date on healthcare, authorization processes, policies and procedures

    Performs other duties as assigned.

    Complies with all policies and standards


    Education/Experience:
    Requires a High School diploma or GED

    Entry-level position typically requiring little or no previous experience.


    Skills:
    Prior authorization, 30+ wpm, provider relations, medical terminology, medical record


    Top Skills Details:
    Prior authorization,30+ wpm,provider relations,medical terminology


    Additional Skills & Qualifications:
    What previous job titles or background work well in this role?


    • Referral Specialist
    • Medical Biller or Medical Coder
    • Customer Service Representative

    Experience Level:
    Entry Level


    About TEKsystems:
    We're partners in transformation. We help clients activate ideas and solutions to take advantage of a new world of opportunity.

    We are a team of 80,000 strong, working with over 6,000 clients, including 80% of the Fortune 500, across North America, Europe and Asia.

    As an industry leader in Full-Stack Technology Services, Talent Services, and real-world application, we work with progressive leaders to drive change.

    That's the power of true partnership. TEKsystems is an Allegis Group company.


    The company is an equal opportunity employer and will consider all applications without regards to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.

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