AUTHORIZATION SPECIALIST II

Hiring for Authorizations SpecialistDescription:Position Purpose:Acts as a resource and supports the prior authorization request process to ensure that all authorization requests are addressed properly in the contractual timeline. Supports utilization management team to document authorization requests and obtain accurate and timely documentation for services related to the members healthcare eligibility and access.Education/Experience:Requires a High School diploma or GEDRequires 1 - 2 years of related experience.Knowledge of medical terminology and insurance preferred. Aids the utilization management team and maintains ongoing tracking and appropriate documentation on authorizations and referrals in accordance with policies and guidelinesSupports the authorization review process by researching and documenting necessary medical information such as history diagnosis and prognosis based on the referral to the clinical reviewer for determinationVerifies member insurance coverage and/or service/benefit eligibility via system tools and aligns authorization with the guidelines to ensure a timely adjudication for paymentPerforms data entry to maintain and update various authorization requests into utilization management systemSupports and processes authorization requests for services in accordance with the insurance prior authorization list and routes to the appropriate clinical reviewerRemains up-to-date on healthcare authorization processes policies and proceduresPerforms other duties as assignedComplies with all policies and standardsExperience Level:2+ years of experience initiating and processing Prior Authorizations and ReferralsAbout TEKsystems:

We're partners in transformation. We help clients activate ideas and solutions to take advantage of a new world of opportunity. We are a team of 80,000 strong, working with over 6,000 clients, including 80% of the Fortune 500, across North America, Europe and Asia. As an industry leader in Full-Stack Technology Services, Talent Services, and real-world application, we work with progressive leaders to drive change. That's the power of true partnership. TEKsystems is an Allegis Group company.The company is an equal opportunity employer and will consider all applications without regards to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.