Prior Authorization Specialist - LanceSoft Inc
Detroit, MI 48226
About the Job
Job Description
- Training will be onsite in Detroit, MI - Thereafter it's a remote role
- Support Client's providers and UM reviewers with prior authorization requests for post-acute care services.
- Includes manually entering authorization requests into client's Care Management systems, following rules and algorithms embedded in the care management system to administratively approve prior authorization requests.
- May work with providers to secure discharge plans,
- Notice of Non-Medical Coverage, Durable medical equipment, and other home supports required for discharge planning. May support scheduling physician to physician calls.
- Will support appeal processes for Client designated Quality Improvement Organization appeals including logging all appeal activities.
- High School Graduate or GED equivalent required.
- Two years of college preferred.
- Two years experience as medical assistant, care technician, post-acute care and home health care support staff or ancillary services in other health care related field preferred.
- Knowledge post-acute care functions and processes or discharge readiness activities may be preferred for some positions.
Source : LanceSoft Inc