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

Disclaimer Jobs are posted by independently owned and operated provider agencies. Your application will go directly to the agency, and all hiring decisions will be made by the management of the agency. All inquiries about employment should be made directly to the agency location. This aggregate job board is hosted by the Homecare and Hospice Association of Utah (HHAU). HHAU does not have access to candidate information and is not responsible for any of the job postings other than those posted for positions where HHAU is the employer.