Prior Authorization & Appeals Specialist

Mountain Area Health Education Center; Asheville (NC); On-site; USD 42,000 - 60,000; Full time

Job summary

MAHEC in Asheville is seeking a Prior Authorization Specialist to manage authorizations for in-house procedures, Medicare HMO visits, radiology, and behavioral health. You will collaborate with clinics and referrals teams to obtain approvals, address denials, support Peer-to-Peer requests and Appeals, and assist with other areas needing authorizations and referrals.

Ideal candidates will have some college and healthcare administration experience, proficiency with Microsoft Office and Allscripts

Qualifications

• Some college or equivalent healthcare-related experience, with focus on utilization review.
• Prior authorization experience preferred.

Responsibilities

• Obtain and request prior authorizations for in-house procedures, Medicare HMO visits, radiology, and behavioral health.
• Collaborate with clinics and referrals teams to secure approvals and handle denials.
• Assist with Peer-to-Peer requests and Appeals and support other areas needing authorizations and referrals.

Skills

Typing

MS Office

Data Entry

Allscripts EHR

Spanish (optional)

Education

Some college / healthcare admin experience

Tools

Allscripts EHR

Job description

MAHEC in Asheville is seeking a Prior Authorization Specialist to manage authorizations for in-house procedures, Medicare HMO visits, radiology, and behavioral health. You will collaborate with clinics and referrals teams to obtain approvals, address denials, support Peer-to-Peer requests and Appeals, and assist with other areas needing authorizations and referrals.

Ideal candidates will have some college and healthcare administration experience, proficiency with Microsoft Office and Allscripts