Authorization Representative

Benefits:

• 401(k)
• Competitive salary
• Health insurance
• Paid time off
• Vision insurance

Immediate Opening: Authorization Representative

We have an exciting opportunity for an Authorization Representative at our corporate office in Murray. We are looking for a well-organized and professional team member with a positive attitude to join our Accounts Receivable Department.

Key Responsibilities:

• Facilitate daily authorization requests with a variety of insurance carriers, including Commercial insurance companies nationwide, Utah and New Mexico State Medicaid plans, MCO/ACO Medicaid Plans, and Medicare Advantage plans.
• Obtain prior authorization for services from clients' medical insurance carriers.
• Review client orders and clinical notes to accurately request authorizations.
• Maintain up-to-date knowledge of insurance carriers' prior authorization requirements.
• Ensure that all procedure codes and units of measure align with the service, contract, and insurance guidelines.
• Communicate effectively with other departments to obtain necessary clinical documentation.
• Submit quality authorization/review documentation verbally, online, or via fax/email to insurance carriers.
• Document authorizations accurately and timely in our system and maintain detailed records.
• Follow up on delayed or denied authorization requests and escalate as needed.
• Advocate for clients regarding their care and insurance benefits.
• Respond to inquiries from patients, staff, and insurance companies about authorizations.
• Prioritize workflow to meet company and department needs.
• Problem-solve issues and identify optimal solutions.
• Provide backup coverage for the Re-Authorization Representative, including handling re-authorizations, monthly Medicaid eligibility checks, expiring authorization reports, and coverage during scheduled or unscheduled time off.
• Perform other tasks and duties as assigned.

Skills, Qualifications, and Experience:

• Basic knowledge of accounting, Adobe, Microsoft Word, Outlook, and Excel.
• Strong attention to detail and accuracy.
• Ability to work efficiently in a fast-paced environment with changing tasks and interruptions.
• Proficient in multitasking and adapting to new or evolving information and procedures.
• Effective verbal and written communication skills.
• Ability to meet processing time standards.
• Professional and courteous in all customer interactions.

Requirements:

• High school diploma.
• Successful completion of a background check upon hire.

Schedule:

• Full-time, in-person position
• Monday through Friday, 8:00 AM to 5:00 PM