Prior Authorization Specialist

Overview:

TekWissen Group is a workforce management provider throughout the USA and many other countries in the world. Our client is a health insurance company. It offers different types of health care coverage plans that include individual and family dental and vision plans for employers etc.

Title: Prior Authorization Specialist

Work Location: Detroit MI 48243

Duration: 5 Months

Job Type: Contract

Work Type: Remote

Job Description

• Support Client providers and UM reviewers with prior authorization requests for postacute care services.

• Includes manually entering authorization requests into Client Care Management systems following rules and algorithms embedded in the care management system to administratively approve prior authorization requests.

• May work with providers to secure discharge plans Notice of NonMedical Coverage Durable medical equipment and other home supports required for discharge planning.

• May support scheduling physician to physician calls.

• Will support appeal processes for CMS designated Quality Improvement Organization appeals including logging all appeal activities.

• High School Graduate or GED equivalent required. Two (2) years of college preferred.

• Two (2) years experience as medical assistant care technician postacute care and home health care support staff or ancillary services in other health care related field preferred.

• Knowledge postacute care functions and processes or discharge readiness activities may be preferred for some positions

TekWissen Group is an equal opportunity employer supporting workforce diversity.