Job Details

Immediate need for a talented Authorization Specialist I. This is a 09 Months Contract opportunity with long-term potential and is located in US (Remote). Please review the job description below and contact me ASAP if you are interested.

Job ID:26-01674

Pay Range: $20 - $21/hour. Employee benefits include, but are not limited to, health insurance (medical, dental, vision), 401(k) plan, and paid sick leave (depending on work location).

Key Responsibilities:

• This request is for support in the admin denial process.
• Will need to review documents received via fax and extract information needed to build authorization.
• Occasionally doing outreach to provider to obtain clarification of request or missing information.
• Required to send out notification of determination and adhere to strict deadlines.
• Will need ability to have good communication skill both verbal and written as letter will need to be created for providers per medical guidelines.
• Supports authorization requests for services in accordance with the insurance prior authorization list.
• Supports and performs data entry to maintain and update authorization requests into utilization management system.
• Assists utilization management team with ongoing tracking and appropriate documentation on authorizations and referrals in accordance with policies and guidelines.
• Contributes to the authorization review process by documenting necessary medical information such as history, diagnosis, and prognosis based on the referral to the clinical reviewer for determination.
• Remains up to date on healthcare, authorization processes, policies, and procedures.
• Performs other duties as assigned.
• Complies with all policies and standards.

Key Requirements and Technology Experience:

• Skills-- Medical background and authorization experience is required.
• Medicaid experience and Excel background is highly preferred.
• Microsoft Office is required.
• Looking for experience in Intake and Authorization, some Medi-Cal knowledge would be helpful for this role as well as pas medical experience.
• Long Term Custodial experience is preferred.
• High School Diploma or GED.

Our client is a leading Healthcare Industry and we are currently interviewing to fill this and other similar contract positions. If you are interested in this position, please apply online for immediate consideration.

Pyramid Consulting, Inc. provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.

By applying to our jobs you agree to receive calls, AI-generated calls, text messages, or emails from Pyramid Consulting, Inc. and its affiliates, and contracted partners. Frequency varies for text messages. Message and data rates may apply. Carriers are not liable for delayed or undelivered messages. You can reply STOP to cancel and HELP for help. You can access our privacy policy here.

#prof