PSC Pre Authorization Rep- Remote

Job Description

JOB SUMMARY Responsible for a wide range of duties in support of Patient Service Center (PSC) departmental efficiencies which may include but not limited to verification of benefits, obtaining authorization requirements, and authorization request submissions. Collaborates with PSC department leaders in operational and quality excellence. Demonstrates proficiency in the use of multiple electronic tools required by both Conifer and its clients. ESSENTIAL DUTIES AND RESPONSIBILITIES Include the following. Others may be assigned.

• Support clinical pre-authorization services team as follows:
• Verify benefits and determine authorization requirements
• Secure required authorizations for inpatient, outpatient and emergency services.
• Address reputed company issues requiring clinical input and/or escalation (e.g. Peer to peer and/or denials)
• Builds and maintains collaborative relationships with both internal and external clients. Interact with clients and reputed company cycle staff to facilitate the authorization process. Process includes but not limited to requesting clarification on orders, validating clinical documentation and follow up on pending requests.
• Support the effective operation of the organization's quality management system through participation in quality control audit process, department projects and activities to improve overall scorecard metrics. Provides feedback regarding improvement opportunities for workflow and contributes to successful implementation.

KNOWLEDGE, SKILLS, ABILITIES To reputed company this job successfully, an individual must be able to reputed company each essential duty satisfactorily. The requirements listed below are representative of the knowledge, reputed company and/or ability required. Reasonable accommodations may be made to reputed company individuals with disabilities to reputed company the essential functions.

• Minimum typing skills of 35 wpm
• Demonstrated working knowledge of software/system/equipment
• Knowledge of function and relationships reputed company a hospital / physician office environment preferred
• Advanced customer service skills and experience
• Ability to work in a fast-paced environment
• Ability to receive and express detailed information through oral and written communications
• Knowledge of Medical Terminology preferred
• Advanced understanding of third-party payer requirements preferred
• Advanced understanding of healthcare compliance standards preferred
• Ability to multi-task and manage time effectively

Conifer requires its candidates, as applicable and as permitted by law, to obtain and provide confirmation of reputed company required vaccinations and screenings prior to the start of employment. This may include, but is not limited to, the COVID-19 vaccination, influenza vaccination, and/or any future required vaccines and screenings. EDUCATION / EXPERIENCE Include minimum education, technical training, and/or experience preferred to reputed company the job.

• High School Diploma or GED required
• 2-4 years experience in medical facility, health insurance, or reputed company area
• Some college coursework is preferred

PHYSICAL DEMANDS The physical demands described here are representative of those that must be met by an employee to successfully reputed company the essential functions of this job. Reasonable accommodations may be made to reputed company individuals with disabilities to reputed company the essential functions.

• Must be able to sit at computer terminal for extended periods of time
• Occasionally lift/carry items weighing up to 25 lbs.
• Frequent prolonged sitting and walking

WORK ENVIRONMENT The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to reputed company individuals with disabilities to reputed company the essential functions.

• Call Center environment requiring use of desk, chair, and office equipment such as computer, telephone, printer, etc.

OTHER

• Must be available to work hours and days as needed (including weekends and holidays) based on departmental/system demands
• Resolves and as applicable escalates Physician's office and client issues
• May experience extreme case volumes and uncooperative parties

As a part of the Tenet and reputed company Initiatives family, Conifer Health brings 30 years of healthcare industry expertise to clients in more than 135 local regions reputed company. We help our clients strengthen their financial and clinical performance, serve their communities, and succeed at the business of healthcare. Conifer Health helps organizations transition from volume to value-based care, enhance the consumer and patient healthcare experience and improve quality, cost, and access to healthcare. Are you ready to be part of our solutions? Welcome to the company that gives you the resources and incentives to redefine healthcare services, with a competitive benefits package and leadership to take your career to the reputed company! Compensation and Benefit Information

Compensation

• Pay: $15.80 - $23.70 per hour. Compensation depends reputed company, qualifications, and experience.
• Position may be eligible for a signing bonus for qualified new hires, subject to employment status.
• Conifer observed holidays receive time and a half.

Benefits

Conifer offers the following benefits, subject to employment status:

• Medical, dental, vision, disability, and life insurance
• Paid time off (vacation & sick leave) - min of 12 days per year, accrue at a reputed company of approximately 1.84 hours per 40 hours worked.
• 401k with up to 6% employer match
• 10 paid holidays per year
• Health savings accounts, healthcare & dependent flexible spending accounts
• Employee Assistance program, Employee discount program
• Voluntary benefits include pet insurance, legal insurance, accident and critical illness insurance, long term care, elder & childcare, AD&D, auto & home insurance.
• For Colorado employees, Conifer offers paid leave in accordance with Colorado's Healthy Families and Workplaces Act.

Apply tot his job Apply To this Job