Pre-Auth (Prior Authorization) Consultant
Magicforce
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.
Vacancy posted 23 days ago
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