[Hiring] Prior Authorization Specialist @Alpine Physician Partners

This description is a summary of our understanding of the job description. Click on 'Apply' button to find out more. Role Description This role involves evaluating referral and pre-certification requests in accordance with contractual obligations and regularly interacting with physician offices to assist with prior authorizations. • Communicates well both verbally and in writing • Creates accurate and punctual reports • Delivers presentations and shares information and ideas with others • Develops and maintains good working relationships with team members, other departments, medical directors, and provider offices • Breaks down problems into smaller components and understands underlying issues • Answers phones regarding questions related to prior authorization • Manages a fair workload and volunteers for additional work • Follows documented processes to review healthcare service requests • Seeks out and accepts feedback, is a proactive learner • Builds customer confidence and is committed to increasing customer satisfaction • Participates as part of the Prior Authorization team by actively interacting with other team members • Evaluates referral and pre-certification requests to determine eligibility and network affiliation Qualifications • High School diploma/GED; MA or Associates degree highly preferred • One to three years healthcare experience required (medical office, healthplan, etc.) • One to three years utilization management experience highly preferred • Knowledge of medical terminology required • Knowledge of medical coding, NCQA and Medicare Guidelines required • Proven customer service skills required • Excellent written and verbal communications skills required • Skilled in computer competency using Microsoft Outlook, Word and Excel • Ability to work in a windows based environment utilizing numerous programs at once • Ability to work in a fast-paced environment • Ability to identify and solve practical problems • Ability to maintain positive and effective work relationships with coworkers, clients, members, and providers • Strong organizational skills • Strong attention to detail • Home office that is HIPAA compliant for all remote or telecommuting positions as outlined by the company policies and procedures Requirements • Salary Range: $19.71 - $26.28