Prior Authorizations Agent
hace 1 mes
**RedValley, the coolest and fast-growing company**, is seeking a _Prior Authorizations Agent_ for our new medical team This position is responsible for obtaining pre-certifications and pre-authorizations for procedures and medications, scheduling appointments for outpatient testing with other providers, transcribing and triaging patient calls to physicians, and coordinating patient appointments/orders.
**What You'll Do**
- Review chart documentation to ensure the patient meets medical policy guidelines
- Prioritize incoming authorization requests according to the urgency
- Obtain authorization via the payer website or by phone and follow up regularly on pending cases
- Maintain individual payer files to include up-to-date requirements needed to successfully obtain authorizations
- Initiate appeals for denied authorizations
- Respond to clinic questions regarding payer medical policy guidelines
- Confirm accuracy of CPT and ICD-10 diagnoses in the procedure order
- Contact patients to discuss authorization status
- Other duties as assigned
**What You'll Bring to the Team**
- Strong spoken and written English (C1 or better).
- Experience with procedure authorizations in any medical field.
- Basic typing and keyboarding skills.
- Strong oral and written communication skills.
- Good interpersonal and organizational skills.
- Highly detail-oriented.
- Basic understanding of human anatomy, specifically musculoskeletal
- Proficient use of CPT and ICD-10 codes
**What You'll Get Working With Us**
- Opportunities to work in a fast-paced startup environment supportive of teamwork, ownership, and purpose.
- Flexible working environment (flexible working hours, working from our state-of-the-art office space in El Poblado).
- One-of-a-kind company values and teamwork culture as well as a meaningful mission and challenging work.
- Private health insurance for you plus a family member.
- The opportunity to create an impact in Medellin (and the world) is real. Our newest venture, a non for profit foundation called RVLOVE, is providing real opportunities and resources to those in underserved areas in Medellín.
- Subsidized breakfast & lunch at our very own RedValley Café.
Tipo de puesto: Tiempo completo
Salario: $3.000.000 - $3.500.000 al mes
Idioma:
- Ingles (Obligatorio)
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