Title: Prior Authorization Specialists – multiple openings
Location: Detroit, MI
Duration: 12+ Months
Role Type: W2 contract engagement
Pay Rate: 22-24/HR
ROLE SUMMARY
Medicare Advantage Post-Acute Care Specialist:
- Support healthcare providers and UM reviewers with prior authorization requests for post-acute care services.
- Includes manually entering authorization requests into healthcare system, 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 CMS designated Quality Improvement Organization appeals including logging all appeal activities.
Requirements:
- High School Graduate or GED equivalent required.
- Two (2) years of college preferred.
- Two (2) 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 of post-acute care functions and processes or discharge readiness activities may be preferred for some positions
Job Type: Contract
Pay: $22.00 - $24.00 per hour
Weekly day range:
- Monday to Friday
- No weekends
Application Question(s):
- This role is 100% remote for candidates located in Michigan. Are you local to Michigan? If not, applications would automatically be rejected.
- This role would require 2-3 weeks of onsite training in downtown Detroit, MI then would transition to fully remote, would this be fine?
Experience:
- Pri- Authorization: 2 years (Preferred)
- Post-acute care: 2 years (Preferred)
- CMS: 2 years (Preferred)
Location:
Work Location: Remote