Pre-Authorization Specialist - Remote in WA or OR

Talentify.io; United States; Remote; USD 60,000 - 80,000; Full time

Job summary

A leading company in healthcare services offers a remote position focusing on managing referral authorizations. This role requires knowledge of health plan operations and proficiency in EHR systems. The company provides a supportive culture with comprehensive benefits and opportunities for career advancement.

Benefits

Comprehensive benefits package including 401k contributions

Equity stock purchase

Flexible work hours

Supportive and inclusive work culture

Qualifications

• 2+ years of experience in healthcare, focusing on health plan operations.
• Ability to work full-time with flexibility for 8-hour shifts.

Responsibilities

• Manage referral authorizations and ensure compliance with health plan requirements.
• Assist patients with inquiries related to referrals.
• Document patient information in the electronic health record.

Skills

Proficiency in EHR/EMR systems

Communication

Problem-solving

Education

High School Diploma or GED

Tools

Epic

Job description

Employer Industry: Healthcare Services

Why consider this job opportunity:
- Salary up to $33.22 per hour
- Comprehensive benefits package including 401k contributions and equity stock purchase
- Opportunity for career advancement and growth within the organization
- Work remotely if located in Washington or Oregon
- Supportive and inclusive work culture
- Flexible work hours during normal business operations

What to Expect (Job Responsibilities):
- Initiate and manage referral authorizations and ensure compliance with health plan requirements
- Assist patients, staff, and physicians with inquiries related to referrals and authorization processes
- Research and process denied claims due to missing authorizations or referrals
- Document patient information accurately in the electronic health record
- Collaborate with clinical teams and health plans to enhance the referral and authorization management process

What is Required (Qualifications):
- High School Diploma or GED
- Must be 18 years of age or older
- 2+ years of experience in healthcare, with a focus on health plan operations
- Proficiency in EHR/EMR systems, specifically Epic
- Ability to work full-time with flexibility to accommodate 8-hour shift schedules

How to Stand Out (Preferred Qualifications):
- 1+ years of experience in referrals/pre-authorization management
- Experience in appeal writing and processing
- Knowledge of CPT & Diagnosis Coding, Medical Terminology, and basic Anatomy
- Familiarity with EOB, COB, Remits, and CMS 1500 documentation
- Understanding of organizational policies and procedures

#HealthcareServices #RemoteWork #CareerGrowth #ComprehensiveBenefits #HealthcareCareers

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