Prior Authorization Clerk

Healthcare Support Staffing; Richmond (VA); On-site; USD 35,000 - 50,000; Full time

Job summary

A national healthcare staffing firm is seeking a candidate for a medical call center role in Richmond, Virginia. The position involves handling authorization requests, coordinating precertifications, and responding to inquiries from clients and providers. Ideal candidates should have at least one year of relevant experience and strong communication skills, alongside a solid understanding of medical terminology. Work hours are Monday to Friday from 8:30 AM to 5 PM.

Qualifications

• 1 year of relevant experience in a medical or healthcare environment.
• Strong analytical, written and oral communication abilities.
• Knowledge of medical terminology is essential.

Responsibilities

• Manage incoming calls or post-service claims work.
• ID and data entry of referral requests into the UM system.
• Respond to inquiries from clients, providers, and in-house departments.
• Determine contract and benefit eligibility.
• Provide authorizations for admissions and precertifications.

Skills

Analytical skills

Written communication

Oral communication

Knowledge of medical terminology

Job description

HealthCare Support Staffing, Inc. (HSS), is a proven industry-leading national healthcare recruiting and staffing firm. HSS has a proven history of placing talented healthcare professionals in clinical and non-clinical positions with some of the largest and most prestigious healthcare facilities including: Fortune 100 Health Plans, Mail Order Pharmacies, Medical Billing Centers, Hospitals, Laboratories, Surgery Centers, Private Practices, and many other healthcare facilities throughout the United States. HealthCare Support Staffing maintains strong relationships with top providers in healthcare and can assure healthcare professionals they will receive fast access to great career opportunities that best fit their expertise. Connect with one of our Professional Recruiting Consultants today to see how a conversation can turn into a long-lasting and rewarding career!

Job Description

Working in medical call center to handle requests for authorizations. Coordinating cases for precertification and prior authorization review

Daily Responsibilities

• Managing incoming calls or incoming post services claims work
• ID and data entry of referral requests into the UM system in accordance with the plan certificate
• Respond to telephone and written inquiries from clients, providers and in house departments.
• Determine contract and benefit eligibility
• Provide authorization for inpatient admission, outpatient precertification, prior authorization and post services requests.

Qualifications

• 1 year relevant experience
• Strong analytical, written and oral communication
• Knowledge of medical terminology a must

Additional Information

Hours for this Position:

M-F 8:30am-5pm

Want More Information?

Interested in hearing more about this great opportunity? Reach out to Stephanie Zymowski at 407-636-7030 ext220 for immediate consideration.