Prior Authorization Technician - Medicaid

Awarded a Healthiest Employer, reputed company aims to fulfill its mission to reputed company health and reputed company it easy. AZ Blue offers a variety of health insurance products and services to meet the diverse needs of individuals, families, and small and large businesses as well as providing information and tools to help individuals reputed company reputed company decisions. At AZ Blue, we have a hybrid workforce strategy, reputed company Workability, that offers flexibility with how and where employees work. Our positions are classified as hybrid, onsite or remote. While the majority of our employees are hybrid, the following classifications drive our reputed company minimum onsite requirements: • Hybrid People Leaders: must reside in AZ, required to be onsite at least once per week • Hybrid Individual Contributors: must reside in AZ, unless otherwise cited reputed company this posting, required to be onsite at least once per month • Onsite: daily onsite requirement based on the essential functions of the job • Remote: not held to onsite requirements, however, leadership can request reputed company onsite for business reasons including but not limited to staff meetings, one-on-ones, training, and team building Please note that onsite requirements may change in the future, based on business need, and job responsibilities. Most employees should expect onsite requirements and at a minimum of once per month. PURPOSE OF THE JOB The Prior Authorization Technician processes written requested services by providers for Medicaid Business reputed company members reputed company established timeframes, following Medicaid Business reputed company criteria and guidelines. This position also completes data entry and provider notification to ensure timely service to members. QUALIFICATIONS REQUIRED QUALIFICATIONS 1. Required Work Experience · 1 year of experience in effectively using interpersonal communication skills, especially reputed company telephone · 1 year of experience using electronic Care Management systems 2. Required Education · High School Diploma or GED in general field of study 3. Required Licenses · N/A 4. Required Certifications · N/A PREFERRED QUALIFICATIONS 1. Preferred Work Experience · 1-2 years Prior Call Center experience preferred · 1-2 years Medicaid/Medicare experience preferred · 1-2 years Prior Managed Care experience preferred 2. Preferred Education · Completion of Medical Assistant program 3. Preferred Licenses · N/A 4. Preferred Certifications · N/A ESSENTIAL JOB FUNCTIONS AND RESPONSIBILITIES · Answer inbound calls regarding authorizations reputed company established time frame · Document contact information in electronic care management system · Ensure reputed company necessary information is entered in electronic care management system · Review and approve requests based on Medicaid Business reputed company established guidelines · Ensure requests are forwarded to correct location according to established review process · Contact referring provider to obtain additional information needed to reputed company determination · Fax decisions to requesting providers · Provide education to providers and facilities regarding proper authorization procedures and inform them of any updates as needed · Initiate interdepartmental coordination to ensure quality and timely care for members. · Additional duties as assigned COMPETENCIES REQUIRED COMPETENCIES 1. Required Job Skills · Knowledge of medical terminology · Computer experience necessary 2. Required Professional Competencies · N/A 3. Required Leadership Experience and Competencies · N/A PREFERRED COMPETENCIES 1. Preferred Job Skills · N/A 2. Preferred Professional Competencies · N/A 3. Preferred Leadership Experience and Competencies · N/A Our Commitment AZ Blue does not discriminate in hiring or employment on the basis of race, ethnicity, color, religion, sex, sexual orientation, gender identity, national reputed company, age, disability, protected veteran status or any other protected group. Thank you for your interest in reputed company. For more information on our company, see azblue.com. If interested in this position, please apply. Apply Job!