LanceSoft
Prior Authorization Specialist
LanceSoft - Detroit, Michigan, United States, 48228
Work at LanceSoft
Overview
- View job
Overview
Job Description
Training will be onsite in Detroit, MI - Thereafter it's a remote role Support Client's providers and UM reviewers with prior authorization requests for post-acute care services. Includes manually entering authorization requests into client's Care Management systems, 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 Client designated Quality Improvement Organization appeals including logging all appeal activities. Requirements:
High School Graduate or GED equivalent required. Two years of college preferred. Two 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 post-acute care functions and processes or discharge readiness activities may be preferred for some positions.
Training will be onsite in Detroit, MI - Thereafter it's a remote role Support Client's providers and UM reviewers with prior authorization requests for post-acute care services. Includes manually entering authorization requests into client's Care Management systems, 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 Client designated Quality Improvement Organization appeals including logging all appeal activities. Requirements:
High School Graduate or GED equivalent required. Two years of college preferred. Two 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 post-acute care functions and processes or discharge readiness activities may be preferred for some positions.