Authorization Specialist I

Position Purpose: Supports the prior authorization request to ensure all authorization requests are addressed properly and in the contractual timeline. Aids 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 GED. Entry-level position typically requiring little or no previous experience. Understanding of medical terminology and insurance preferred. Supports authorization requests for services in accordance with the insurance prior authorization list Supports and performs data entry to maintain and update authorization requests into utilization management system Assists utilization management team with ongoing tracking and appropriate documentation on authorizations and referrals in accordance with policies and guidelines Contributes to the authorization review process by documenting necessary medical information such as history, diagnosis, and prognosis based on the referral to the clinical reviewer for determination Remains up-to-date on healthcare, authorization processes, policies and procedures Performs other duties as assigned Top 3 must-have hard skills stack-ranked by importance 1Word, excel 2 Attention to Detail 3Team oriented  

salary: $22.99 - $23 per hour
shift: First
work hours: 8 AM - 5 PM
education: High School

Responsibilities

Supports authorization requests for services in accordance with the insurance prior authorization list
Supports and performs data entry to maintain and update authorization requests into utilization management system
Assists utilization management team with ongoing tracking and appropriate documentation on authorizations and referrals in accordance with policies and guidelines
Contributes to the authorization review process by documenting necessary medical information such as history, diagnosis, and prognosis based on the referral to the clinical reviewer for determination
Remains up-to-date on healthcare, authorization processes, policies and procedures
Performs other duties as assigned

Skills

• Word, excel
• Attention to Detail
• Team oriented

Qualifications

• Years of experience: 0 years
• Experience level: Experienced

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Equal Opportunity Employer: Race, Color, Religion, Sex, Sexual Orientation, Gender Identity, National Origin, Age, Genetic Information, Disability, Protected Veteran Status, or any other legally protected group status.

At Randstad, we welcome people of all abilities and want to ensure that our hiring and interview process meets the needs of all applicants. If you require a reasonable accommodation to make your application or interview experience a great one, please contact View email address on randstadusa.com.

Pay offered to a successful candidate will be based on several factors including the candidate's education, work experience, work location, specific job duties, certifications, etc. In addition, Randstad offers a comprehensive benefits package, including: medical, prescription, dental, vision, AD&D, and life insurance offerings, short-term disability, and a 401K plan (all benefits are based on eligibility).

This posting is open for thirty (30) days.

It is unlawful in Massachusetts to require or administer a lie detector test as a condition of employment or continued employment. An employer who violates this law shall be subject to criminal penalties and civil liability.