Healthcare Prior Authorizations Specialist - REMOTE

Healthcare Prior Authorization Specialist - REMOTEQuadris Team, LLC - a Revenue Cycle Management Group, is searching for a dynamic person to join our highly skilled Authorizations Team to fill the role ofPrior Authorization Specialist.We are a 100% remote team supporting clients across the United States.The ideal applicant will reside in Pacific or Mountain Standard Time.Job FocusResponsible for obtaining prior authorizations for facility services based on assigned specialty or clinic area.Secure the prior authorization and notify the rendering party in the timeliest manner possible so patients can receive necessary care and services with the least delay.Primary ResponsibilitiesAccurately, efficiently and timely work prior authorization requests-referralsReceive request for prior authorizations through the electronic health record (EHR) and / or via phone, email or fax and ensure that they are properly tracked and monitoredTranscribe incoming referrals into the electronic record (EHR) ensuring accurate patient data entryMonitor incoming referral WQ's to verify insurance eligibility and referral requirements, facilitating timely patient schedulingProcess referrals and submit medical records to insurance carriers to expedite prior authorization processesManage correspondence with insurance companies, physicians, specialists and patients as needed, including documenting in the EHR as appropriateAssist with medical necessity documentation to expedite approvals and ensure that appropriate follow-up is performedReview accuracy and completeness of information requested and ensure that all supporting documents are presentReview denials and follow up with provider to obtain medically necessary information to submit an appeal of the denialPrioritize the incoming authorizations by level of urgency and date of serviceSecure patient information in accordance with client policy / proceduresOther duties as assignedMonitors WQs, and resolves accounts in a timely mannerStay up to date on insurance company policies and procedures related to prior authorizationsPhysical / Mental Demands & EnvironmentProlonged periods of sitting at a desk and working on a computerMust be able to lift 15 pounds at one timeMust structure your home office to ensure patient information is secure meeting the regulatory expectationsSkills Needed to Be SuccessfulMaintains compliance with regulations and laws applicable to jobProfessional level of communication via video, phone, and emailAbility to effectively prioritize work to meet deadlines and expectationsMeets the quality and productivity measures as outlined by QuadrisBrings positive energy to workUses critical thinking skillsBeing present and focused on assigned tasks and eliminates distractionsBeing a self-starterAbility to work independently and within a team atmosphereCore Talent EssentialsHigh School diploma or equivalent1years of experience working in health care, medical billing, with a focus on prior authorization preferredPACS (Prior Authorization Certified Specialist) Certification preferredKnowledge of insurance process and medical terminology preferredHonors and sets high expectations for patient confidentiality and customer service in accordance with Quadris Team policies and procedures and HIPAA requirementsAdvanced level of industry standard electronic medical record contentMust have professional level skills in MS products such as Excel, Word, Power PointProficient application of business / office standard processes and technical applicationsQuadris is an Equal Employment Opportunity employer.Any offer of employment is contingent upon a criminal background check, previous employment verification and references, following all federal and state regulations.Quadris Team is a participant of eVerify.Seniority LevelEntry levelEmployment TypeFull-timeJob FunctionHealth Care ProviderIndustriesHospitals and Health Care#J-18808-Ljbffr. Experience: 3 years required