Prior Authorization Coordinator

https://www.auxiant.com/

Auxiant’s Mission Statement and Core Values

Mission:
An Independent TPA investing in People and Innovation to deliver expert-driven experiences with REAL Results.

Core Values: Independent Solutions. REAL Results
Respect
Empowerment
Agility
Leadership

Be part of a growing and prospering company as a Prior Authorization Coordinator. Auxiant is a third party administrator of self-funded employee benefit plans with offices in Cedar Rapids, IA, Madison and Milwaukee, WI. Auxiant is a fast-growing,progressive company offering an excellent wage and benefit package.

Job Summary:

The Prior Authorization Coordinator is responsible for the handling and tracking of medical necessity review requests received.

Essential Functions:

· Review plan document language to determine if a requested service is eligible under the health plan

· Forward documentation to the appropriate vendor for medical necessity review

· Draft and send response letters based on interpreting medical necessity determination received from outside vendor

· Track medical necessity reviews internally and by using vendor portals

· Run and review various reporting

· Assist with department questions

· Review Single Case Agreement requests

Nonessential Functions:

· Other duties as assigned or appropriate

Education/Qualifications:

· 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 e-mail, record keeping, routine database activity, word processing, spreadsheet,10-key

· Proven experience in a professional office environment

· High school diploma and 1-2 years related experience; or equivalent combination of education and experience.

*Full benefits including: Medical, Dental, Vision, Flexible Spending, Gym Membership Reimbursement, Life Insurance, LTD, STD, 401K, 3 weeks vacation, 9 paid holidays, casual dress code and more

Job Type: Full-time

Schedule:

• 8 hour shift
• Day shift
• Monday to Friday

Work Location: Remote