Prior Authorisation Specialist

US Tech Solutions; United States; Remote; USD 35,000 - 48,000; Full time

Job summary

Join a leading staffing solutions provider as a Cdr I in Prior Auth & Appeals. In this role, you will support compliance with healthcare regulations while honing your skills in a dynamic team environment. Ideal candidates will possess strong problem-solving abilities, experience in the healthcare sector, and proficiency in Windows applications. A high school diploma or GED is required, paving the way for personal and professional growth.

Qualifications

• 1-year healthcare industry related experience.
• Proficient in Windows applications (Word and Excel).
• Knowledge of medical/pharmacy terminology preferred.

Responsibilities

• Perform non-clinical activities under supervision.
• Review and maintain compliance with ERISA, CMS, and Medicaid requirements.
• Meet business unit objectives as part of a team.

Skills

Problem solving

Analytical ability

Strong written communication

Interpersonal skills

Detail oriented

Organizational skills

Education

HS Diploma or GED

Tools

Windows applications (Word and Excel)

Job description

• Cdr I Prior Auth & Appeals will be responsible for performing non-clinical activities and functions in accordance with policies and procedures, under the supervision of the Clinical Supervisor.
• Responsible for reviewing and maintaining compliance with ERISA, CMS, Medicaid, and client specific requirements. Works as part of the team to meet business unit objectives.

Responsibilities:

• Cdr I Prior Auth & Appeals will be responsible for performing non-clinical activities and functions in accordance with policies and procedures, under the supervision of the Clinical Supervisor.
• Responsible for reviewing and maintaining compliance with ERISA, CMS, Medicaid, and client specific requirements. Works as part of the team to meet business unit objectives.

Experience:

• 1-year healthcare industry related experience (hospital, managed care, physician office, PBM etc). Proficient in Windows applications (Word and Excel).
• Problem solving skills, analytical ability. Strong written communication and interpersonal skills.
• Minimum 25-30 WPM. Detail oriented with excellent organizational skills. Preferred knowledge of prescription drug products, dosage forms and usage.
• Medical / pharmacy terminology background

Education:

• HS Diploma or GED required.

About US Tech Solutions:
US Tech Solutions is a global staff augmentation firm providing a wide range of talent on-demand and total workforce solutions. To know more about US Tech Solutions, please visit www.ustechsolutions.com .
US Tech Solutions is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity,
national origin, disability, or status as a protected veteran.

About the company

Our Talent Your Results - This is the premise behind US Tech Solutions.Our flexible engagement model offers right-fit talent on-demand - when, where and how you need it, so you can achieve your business objectives. We offer contingent, contract-to-hire or direct staffing services.At USTECH, we understand how critical talent is to every organization, as well as how the world of work and the workplace is changing. We offer the most effective means to help you acquire, manage and optimize talent.USTECH was founded in 2000 by Manoj Agarwal. Today, we are a global firm offering talent solutions to 150 customers including 20% of Fortune 500 across Financial Services, Healthcare, Life Sciences, Aerospace, Energy, Retail, Telecom, Technology, Manufacturing, and Engineering.

Notice

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