Referral Navigator Rep

Authorization Navigator

Pride Health is hiring an Authorization Navigator for our client in the medical facility. This is a temporary assignment opportunity and a great way to start working with a top-tier healthcare organization!

Job Details

Schedule: 8:00am to 5:00pm

Location: Remote

Job Type: Contract

Contract Length: 3 months (possibility of extension)

Pay Range: $13/hr- $14/hr *Pay offered is based on experience, expertise, credentialing, and education.

Description

• Coordinate and process incoming faxes related to prior authorization requests.
• Review authorization requests for completeness and identify missing clinical or insurance documentation.
• Communicate with provider offices, clinics, insurance plans, and internal teams to obtain required information.
• Process referrals and prior authorization requests in accordance with payer guidelines and turnaround time requirements.

Required Qualifications

• 24+ years of experience in prior authorizations, referrals, healthcare administration, or healthcare operations.
• Experience working with insurance companies, managed care organizations, or provider offices.
• Knowledge of payer guidelines, authorization requirements, and medical terminology.

Pride-Health offers eligible employee's comprehensive healthcare coverage (medical, dental, and vision plans), supplemental coverage (accident insurance, critical illness insurance and hospital indemnity), 401(k)-retirement savings, life & disability insurance, an employee assistance program, legal support, auto, home insurance, pet insurance and employee discounts with preferred vendors. Equal Employment Opportunity Pride-Health is an equal opportunity employer. We do not discriminate on the basis of the race, religious creed, color, national origin, ancestry, physical disability, mental disability, reproductive health decision making, medical condition, genetic information, marital status, sex, gender, gender identity, gender expression, age, sexual orientation, veteran or military status, or any other characteristic protected by applicable federal, state, or local law. Fair Chance Employment Pride-Health is a Fair Chance employer. We consider all qualified applicants, including those with criminal histories, in a manner consistent with applicable state and local Fair Chance laws and ordinances, including, the California Fair Chance Act and all applicable local Fair Chance ordinances. Accommodations We are committed to providing reasonable accommodations to applicants and employees with disabilities. If you require reasonable accommodation to participate in the application or interview process, or to perform the essential functions of this role, please contact us. Only applicable for San Francisco Candidates: Under the San Francisco Lactation in the Workplace Ordinance, we will provide written notice of lactation accommodation rights, and this notice will automatically be given upon hiring, any inquiry of parental leave or lactation accommodation. Only applicable for Kentucky positions: For this type of employment, state law requires a criminal record check as a condition of employment. This applies to direct care staff (Examples: RN, LPN, Nurse Aides, Therapists) referred to Kentucky nursing facilities, assisted living communities, or long-term care facilities, in accordance with KRS 216.793. #PHC #LI-BG1