[Hiring] Prior Authorization Specialist @Physician Health Partners, LLC

This description is a summary of our understanding of the job description. Click on 'Apply' button to find out more. Role DescriptionThis role involves evaluating referral and pre-certification requests in accordance with contractual obligations. • Regularly interacts with physician offices assisting with prior authorizations. • Communicates well both verbally and in writing, creates accurate and punctual reports, delivers presentations, shares information and ideas with others, has good listening skills.• Develops and maintains a good working relationship with team members, other departments, medical directors, and provider offices. • Breaks down problems into smaller components, understands underlying issues, can simplify and process complex issues. • Answers phones regarding questions related to prior authorization. • Manages a fair workload, volunteers for additional work, prioritizes tasks, develops good work procedures, manages time well, handles information flow. • Follows documented process to review healthcare service requests.• Seeks out and accepts feedback, is a proactive learner, takes on tough assignments to improve skills. • Builds customer confidence, is committed to increasing customer satisfaction, sets achievable customer expectations. • Participates as a part of the Prior Authorization team by actively interacting with other team members to distribute work fairly and resolve issues. • Evaluates referral and pre-certification requests to determine eligibility and network affiliation. Qualifications• High School diploma/GED; MA or Associates degree highly preferred• One to three years healthcare experience required (medical office, healthplan, etc.)• One to three years utilization management experience highly preferred• Knowledge of medical terminology required• Knowledge of medical coding, NCQA and Medicare Guidelines required• Proven customer service skills required• Excellent written and verbal communications skills required• Skilled in computer competency using bolthires Outlook, Word and Excel• Ability to work in a windows based environment utilizing numerous programs at once• Ability to work in a fast pace environment• Ability to identify and solve practical problems• Ability to maintain positive and effective work relationships with coworkers, clients, members, and providers• Strong organizational skills• Strong attention to detailRequirements• Home office that is HIPAA compliant for all remote or telecommuting positions as outlined by the company policies and proceduresBenefits• Salary Range: $19.71 - $26.28Company DescriptionAlpine is growing, and we welcome new talent to our highly collaborative and diverse team.We are passionate about building a leading national organization that enables physicians to focus on the joy of practicing medicine, and supports the ongoing transition to value-based care for senior populations. Alpine brings this same level of passion to employee engagement, career development and progression. Apply tot his job