Authorization Specialist I – Medicare

This is a fully remote position, open to applicants in New York.

📋 Description

• Assist with prior authorization requests to ensure they are handled correctly and within the stipulated contractual timelines.

• Support the utilization management team in the documentation of authorization requests.

• Acquire accurate and prompt documentation for services related to members' healthcare eligibility and access.

• Facilitate authorization requests in alignment with the insurance prior authorization list.

• Conduct data entry to maintain and update authorization requests within the utilization management system.

• Help in tracking and documenting authorizations and referrals in accordance with established policies and guidelines.

• Record medical information such as history, diagnosis, and prognosis for the determination of clinical reviewers.

• Keep current on healthcare, authorization processes, policies, and procedures.

• Perform additional duties as assigned.

⛳️ Requirements

• Must have authorization to work in the U.S. without requiring employment-based visa sponsorship now or in the future.

• Previous experience with Medicare is preferred.

• A High School diploma or GED is required.

• Familiarity with medical terminology and insurance is preferred.

• This is an entry-level position typically requiring little or no prior experience.

• Must be able to adhere to all policies and standards.

🏝️ Benefits

• Competitive pay.

• Health insurance.

• 401K.

• Stock purchase plans.

• Tuition reimbursement.

• Paid time off plus holidays.

• Flexible work arrangements including remote, hybrid, field, or office work schedules.

• Additional forms of incentives may be included in total compensation.