Pre-Auth (Prior Authorization) Consultant

Magicforce

Overview:

As a Pre-Auth Consultant you will be a part of an Agile team to build healthcare applications and implement new features while adhering to the best coding development standards .

Mandatory skills

• FACETS UM/Pre-Auth Configuration • ITS/Authorization Routing Logic • SQL & Rule Traceability

Responsibilities: -

7 - 10 years in UM/Pre-Auth configuration within FACETS.

• Familiarity with UM workflows, clinical guidelines, and state mandates.

• Experience working with clinical/utilization management stakeholders

. • Deep understanding of US Healthcare payer operations.

• Ability to analyze complex rules and configurations.

• Strong documentation and communication skills.

Educational Qualifications: -

Engineering Degree - BE/ME/BTech/MTech/BSc/MSc.

• Technical certification in multiple technologies is desirable.

Skills:

ITS/Authorization Routing Logic,SQL & Rule Traceability,FACETS UM/Pre-Auth Configuration

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Vacancy posted 3 hours ago

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