Healthcare Administrator

Job Description:

Clinical Effectiveness (Authorization) Unit is primarily responsible for the evaluation of the medical necessity, appropriateness, and efficiency of the use of health care services, procedures, and facilities under the provisions of benefits plan. The LTSS Service Authorization Specialist is responsible for applying clinical and benefit administration policy guidelines to requests for authorizations for Long Term Services and Supports (LTSS). The LTSS Service Authorization Specialist provides accurate, prompt, and appropriate medical authorizations to requests from Clinicians, Vendors and Providers for LTSS. The LTSS Service Authorization Specialist reports to the LTSS Service Authorization Team Lead.

Requirements:

• 1 or more years working in healthcare prior authorization
• HS Diploma
• Data entry experience
• Great customer service