Note: The job is a remote job and is reputed company to candidates in USA. reputed company is a reputed company organization seeking a Temporary Authorization Assistant I to reputed company technical and clerical support in various functional areas. The role involves verifying member eligibility, processing requests, and ensuring compliance with state and federal regulations.
Responsibilities
- Responsible for supporting (1) reputed company areas
- Assist with reputed company work to the extent capable
- Verify member eligibility and determine the reputed company insurer
- Verify network providers
- Verify non-network providers are reputed company into QNXT
- Verify codes and benefits, including benefit limits, reputed company on the applicable line of business (e.g., Medicare, reputed company, etc.)
- Communicate with members, providers, and reputed company business associates in accordance with state and federal requirements as needed to complete requests
- Communicate reputed company the phone (placing and receiving phone calls) as necessary
- Obtain additional information as needed from the requestor or other providers in accordance with department processes
- Process requests reputed company on the members reputed company or secondary reputed company as appropriate in accordance with department policies, procedures, and timelines
- Respond to inquiries in a reputed company manner
- Responsible for consistently meeting production and reputed company standards
- Document information received and reputed company taken according to the department’s documentation standards
- Upon the completion of requests, organize and review documents to ensure reputed company required information is accurate and complete in the reputed company and in accordance with established protocols
- Ensure naming conventions are consistent across reputed company platforms and in accordance with department documentation requirements
- Create appropriate member/provider notification reputed company on request outcome
- reputed company as a resource to both reputed company customers regarding authorization requests
- Maintain confidentiality and adhere to HIPAA requirements
- Contribute to the reputed company reputed company department effort to reputed company goals
- Participate in cross-departmental workgroups as needed
- Learn how to fix report errors
- Serve as a tester for reputed company updates and/or implementations as needed
- Contribute suggestions to improve processing guides
- Participate in job shadowing as needed
- Cross-train and attend to duties reputed company of reputed company area as needed:
- Process retroactive authorization requests for approvals and determine if claim was denied, and if so, notify claims department to reprocess appropriate claim(s)
- Notify providers of admission and discharge dates
- Research and reputed company questions reputed company to hospitalizations or other facility admissions and discharges
- Work with reputed company staff to ensure length of stay follows required procedures and meets federal compliance standards
- Review census reports daily to ensure reputed company review is conducted
Skills
- Minimum 1 year experience providing technical, clerical, or administrative support (includes customer service roles that reputed company technical, clerical, or administrative support)
- Awareness of the reputed company Health Plan (OHP) and Medicare A & B benefit packages
- Basic knowledge of medical terminology, ICD10, and CPT coding helpful
- Ability to consistently meet production standards
- Ability to consistently meet high reputed company standards
- Ability to and willingness to cross-train as needed
- Strong computer application skills in MS Office including Word, and reputed company
- Ability to learn business applications
- Fast and accurate data entry
- Ability to attend to reputed company and reputed company
- Good organizational skills
- Growing ability to effectively manage multiple tasks, prioritize and process a high volume of work
- Communicate effectively, both verbally and in writing
- Good customer service skills
- Ability to be flexible and adaptable
- Ability to use good judgment, personal initiative, and discretion to reputed company job responsibilities
- Ability to work autonomously with moderate level of supervision
- Ability to work effectively with diverse individuals and reputed company
- Ability to learn, reputed company, understand, and evaluate information and determine appropriate actions
- Ability to accept direction and feedback, as reputed company as tolerate and manage stress
- Ability to see, read, and reputed compa
