Prior Authorization Tech

Ardent Health Services; Albuquerque (NM); On-site; USD 36,000 - 60,000; Full time

Job summary

Ardent Health Services is seeking a Day Shift, full-time Prior Authorization Tech in Albuquerque, NM to support the Health Services Department with telephone triage, data entry, and authorization processing. The role involves receiving, screening, and transferring calls, assisting callers with questions, and ensuring adherence to policies for patient safety.

The position requires a High School Diploma or GED, two years of direct patient care experience, and computer skills (Word/Excel) plus

Qualifications

• High School Diploma or GED.
• Two years of experience in direct patient care at a medical office or facility.
• Computer training (Word/Excel), Medical Terminology, working knowledge of CPT, HCPCS, ICD-9 codes, and ACD telephone system.
• Preferred: Medical Assistant Certification.
• Five years of experience in direct patient care at a medical office or facility.

Responsibilities

• Provides telephone triage, data entry and assistance to the Health Services Department in order to ensure quality customer service and exceptional quality management.
• Receives, screens, manages, resolves and/or transfers calls.
• Assists callers with questions and concerns.
• Adheres to policies, procedures and regulations to ensure compliance and patient safety.
• Enters authorizations and recertification requests with accuracy to include eligibility, provider status, and benefit interpretations.

Job description

Overview

Join our team as a day shift, full-time, Prior Authorization Tech in Albuquerque, NM.

Why Join Us?

Thrive in a People-First Environment and Make Healthcare Better

• Thrive: We empower our team with career growth opportunities, tuition assistance, and resources that support your wellness, education, and financial well-being.
• People-First: We prioritize your well-being with paid time off, comprehensive health benefits, and a supportive, inclusive culture where you are valued and cared for.
• Make Healthcare Better: We use advanced technology to support our team and enhance patient care.

Get to Know Your Team:

• Lovelace Medical Group is a multispecialty provider group of over 300 providers, including physicians and advanced practice providers serving a broad range of specialties and primary care.

Responsibilities

• Provides telephone triage, data entry and assistance to the Health Services Department in order to ensure quality customer service and exceptional quality management
• Receives, screens, manages, resolves and/or transfers calls
• Assists callers with questions and concerns
• Adheres to policies, procedures and regulations to ensure compliance and patient safety
• Enters authorizations and recertification requests with accuracy to include eligibility, provider status, and benefit interpretations.

Qualifications

Job Requirements

• High School Diploma or GED
• Two (2) years of experience in direct patient care at a medical office or facility
• Computer training (Word/Excel), Medical Terminology, working knowledge of CPT, HCPC, ICD-9 codes, and ACD telephone system

Preferred Job Requirements

• Medical Assistant Certification
• Five (5) years of experience in direct patient care at a medical office or facility