Job Description
**Overview**
BroadPath is hiring **Prior Authorization Specialist** to work remotely from home. Our **Prior Authorization Specialist** is responsible for reviewing and resolving authorization requests and communicating resolution to the appropriate parties in accordance with the standards and requirements established by the Centers for Medicare and Medicaid.
**Responsibilities**
+ Process authorization requests from intake for completeness and possible approval based on available criteria
+ Research issues utilizing systems and other available resources
+ Assures timeliness and appropriateness of requests according to state, federal and healthcare guidelines
+ Approve/fund requests if available information aligns with criteria
+ Route requests for clinical review as indicated
+ Creates and/or maintains statistics and reporting
**Qualifications**
+ High school diploma or equivalent
+ 1 year of health claims experience, OR one year of customer service/provider service experience in a managed care or healthcare environment
+ Ability to toggle through multiple systems
+ Strong verbal and written communication skills
+ Processing Authorizations with Medicare Part C or D experience
+ Basic knowledge of medical terminology, computer literacy, and proficient keyboarding skills are required
**Diversity Statement**
_At BroadPath, diversity is our strength. We embrace individuals from all backgrounds, experiences, and perspectives. We foster an inclusive environment where everyone feels valued and empowered. Join us and be part of a team that celebrates diversity and drives innovation!_
_Equal Employment Opportunity/Disability/Veterans_
_If you need accommodation due to a disability, please email us at HR@Broad-path.com. This information will be held in confidence and used only to determine an appropriate accommodation for the application process_
_BroadPath is an Equal Opportunity Employer. We do not discriminate against our applicants because of race, color, religion, sex (including gender identity, sexual orientation, and pregnancy), national origin, age, disability, veteran status, genetic information, or any other status protected by applicable law._
**_Compensation:_** _ _ _BroadPath has an effective process for assessing market data and establishing ranges to ensure we remain competitive. You are paid within the salary range based on your experience and market data of the position. The actual salary for this role may vary by location._
Job Tags
Remote work, Work from home,
Similar Jobs
Mercy
...collaborative and unafraid to do a little extra to deliver excellent care - that's just part of our commitment. If that sounds like a good fit for you, we encourage you to apply. For information, please reach out to Stephanie Royer, Nurse Recruiter at ****@*****.***
EssilorLuxottica Group
...better. Because continuing our legacy of the highest optical standards helps us innovate the future in optical care. LensCrafters and Macy's relationship is built around a shared mission of providing customers with the highest quality eye care, a passion for style and a...
LPC Personnel, Inc
...Were looking for a meticulous and organized Data Entry Coordinator to support our team. This role involves accurately entering, updating, and maintaining information across multiple systems and databases. The ideal candidate is a fast and precise typist with a keen...
Kaiser Permanente
Job Summary:The Registered Nurse (RN) II is a professional caregiver who assumes responsibility and accountability for a group of patients... ...monitoring course preferred within the last 2 years.COMPANY: KAISERTITLE: Staff Nurse II (Labor & Delivery)LOCATION: Santa Clara,...
Sprouts Farmers Market
...winning team at Sprouts Farmers Market as an Assistant Produce Manager! Overview of Responsibilities:As the Assistant Produce Manager... ...service through managing and leading one of the busiest teams in our store.Assist the Produce Manager in managing and merchandising the...