Prior Authorization Specialist — Remote After Training

Quadax; United States; Remoto; USD 26.000 - 30.000; Tempo pieno

Descrizione del lavoro

Quadax is seeking a detail‑oriented professional to support prior authorization workflows for health plans. The role combines remote work with an initial onsite training period in Middleburg Heights, OH, ensuring compliance with SOPs and KPI targets.

Applicants must reside in Ohio and have billing experience. Responsibilities include handling payer portals, preparing LOMN forms, and coordinating with insurers and physicians to secure authorizations.

Competenze

• High School diploma or GED required.
• Previous health insurance billing experience preferred.
• Working knowledge of medical terminology.
• Proficient and attentive to details.
• Excellent written and verbal communication skills.
• High attention to detail.
• Ability to maintain confidentiality.
• Proficient in Microsoft Excel and Word.
• Ability to multitask, establish priorities, and work independently.

Mansioni

• Review case and insurance information to customize prior authorization requests.
• Navigate payer portals to initiate/obtain authorization status.
• Provide overview of services being submitted for prior authorization to insurers.
• Answer questions regarding reimbursement processes and testing/treatment specifics.
• Complete LOMN forms as required and fax to physicians.
• Follow up with insurers or physician offices as needed.
• Meet productivity and quality KPI goals.
• Participate in team meetings and share case details.
• Comply with SOPs and company policies.
• Perform other duties as assigned.

Conoscenze

Attention to detail

Excellent communication

Multitasking

Formazione

High School diploma or GED

Strumenti

Microsoft Excel

Microsoft Word

Descrizione del lavoro

Quadax is seeking a detail‑oriented professional to support prior authorization workflows for health plans. The role combines remote work with an initial onsite training period in Middleburg Heights, OH, ensuring compliance with SOPs and KPI targets.

Applicants must reside in Ohio and have billing experience. Responsibilities include handling payer portals, preparing LOMN forms, and coordinating with insurers and physicians to secure authorizations.