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Prior Authorization - Benefit Verification Coordinator




Prior Authorization Coordinator -?needed for a very large healthcare company, located near the Robinson/Pittsburgh, PA area.



  • Apply to this posting for consideration!! I truly look forward to your application!! Damian Sroka



Pay Rate: $18 per hour (possible increase after 90 days!)


Hours: 40hrs per week, Monday -Friday. 8am - 530pm. NO Weekends.




Duties:



  • Position Purpose: Assist in activities related to the medical and psychosocial aspects of utilization and coordinated care.

  • Initiate authorization requests for output or input services in keeping with the prior authorization list. Research claims inquiry specific to the department and responsibility.

  • Perform tasks necessary to promote member compliance such as verifying appointments, obtaining lab results. Assess and monitor inpatient census.

  • Screen for eligibility and benefits. Identify members without a PCP and refer to Member Services. Screen members by priority for case management (CM) assessment. Perform transition of care duties to include but not limited to, contact the member?s attending physician, member or medical power of attorney, other medical providers (home health agencies, equipment vendors) for information pertaining to special needs.


I truly look forward to your application!! Damian Sroka








Qualifications

  • ? ?Education/Experience: High school diploma or equivalent. 2-3 years managed care or physician?s office experience.

  • ? ?Thorough knowledge of customer service, utilization review or claims processing practices in a managed care environment and operation of office equipment such as a personal computer.

  • ? ?Knowledge of medical terminology.



I truly look forward to your application!! Damian Sroka






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