Prior Authorization Assistant

Integrated Resources Inc.; Milwaukee (WI); On-site; USD 40,000 - 60,000; Full time

Job summary

A leading company in workforce solutions is seeking a dedicated individual to manage prior authorization requests within a clinical environment. The role involves processing requests, communicating with healthcare providers, and ensuring documentation is accurate. Ideal candidates will have experience in healthcare settings and knowledge of medical terminology, along with proficiency in Microsoft Office tools.

Qualifications

• Previous experience in a clinical environment.
• Experience in a managed health care setting or insurance environment.

Responsibilities

• Process and document all incoming inpatient and outpatient prior authorization requests.
• Communicate effectively with customers/providers about PA requests status.
• Enter PA requests into the authorization database and prepare documentation.

Skills

Knowledge of Medical Terminology

Tools

Microsoft Office (PowerPoint)

Job description

Integrated Resources, Inc., is led by a seasoned team with combined decades in the industry. We deliver strategic workforce solutions that help you manage your talent and business more efficiently and effectively. Since launching in 1996, IRI has attracted, assembled, and retained key employees who are experts in their fields. This has helped us expand into new sectors and steadily grow.

We’ve stayed true to our focus of finding qualified and experienced professionals in our specialty areas. Our partner-employers know that they can rely on us to find the right match between their needs and the abilities of our top-tier candidates. By continually exceeding their expectations, we have built successful ongoing partnerships that help us stay true to our commitments of performance and integrity.

Our team works hard to deliver a tailored approach for each and every client, which is critical in matching the right employers with the right candidates. We forge partnerships that are meant for the long term and align skills and cultures. At IRI, we know that our success is directly tied to our clients’ success.

Job Description

1. Process and document all incoming inpatient and outpatient prior authorization (PA) requests as outlined by policies and procedures.
2. Contact providers via phone or fax to request additional information or clarification as needed per established process.
3. Communicate effectively with customers/providers (both internally and externally) regarding the status of PA requests.
4. Enter PA requests into the prior authorization database, prepare documentation, and assign tasks to the appropriate staff member for clinical review.
5. Complete special projects as requested.

Qualifications

1. Previous experience in a clinical environment.
2. Previous experience working in a managed health care setting or insurance environment.
3. Knowledge of Medical Terminology.
4. Knowledge of additional Microsoft Office software such as PowerPoint.

Additional Information

All your information will be kept confidential.

The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job.

Reasonable accommodations may be made to enable individuals with disabilities to perform essential functions:

1. Work hours are from 8:30 a.m. to 5:00 p.m. Any additional hours must be approved by a supervisor.
2. The majority of work will be performed at an office desk.