Prior Authorization Representative

A-Line Staffing is now hiring an Prior Authorization Representative for the Columbus, OH Area. This would be full time / 40+ hours per week.

If you are interested in this Prior Authorization Representative position, please contact Melissa Ortiz at mortiz@alinestaffing.com

Prior Authorization Representative Compensation

• The pay for this position is $22
• Benefits are available to full-time employees after 90 days of employment
• A 401(k) with a company match is available for full-time employees with 1 year of service on our eligibility dates

Prior Authorization Representative Highlights

The required shift for this position is Monday - Friday 8:30am - 5pm

Prior Authorization Representative Responsibilities

• Supports 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 determination

• Verifies member insurance coverage and/or service/benefit eligibility via system tools and aligns authorization with the guidelines to ensure a timely adjudication for payment

• Performs data entry to maintain and update various authorization requests into utilization management system

• Supports and processes authorization requests for services in accordance with the insurance prior authorization list and routes to the appropriate clinical reviewer

• Remains up-to-date on healthcare, authorization processes, policies and procedures

• Performs other duties as assigned

• Complies with all policies and standards

• Billing simple single line of service using a template that’s created for each step (changes with each member, but with consistent codes)

Prior Authorization Representative Requirements

• Highschool Diploma or GED

• Medicaid experience a MUST

• Experience with Microsoft Office i.e Word, Excel, PowerPoint

• Experience in Managed Care/Utilization review/Case Management

If you think this Prior Authorization Representative position is a good fit for you, please reach out to me - feel free to e-mail or apply to this posting!