Prior Authorizations Specialist

hace 2 semanas


Medellín, Colombia RVStaffing A tiempo completo

RedValley, the coolest and fastest-growing company, is seeking an experienced _ Prior authorization specialist _ to join our new medical team You will be 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 the accuracy of CPT and ICD-10 diagnoses in the procedure order
  • Contact patients to discuss authorization status
  • Other duties as assigned, aligned with the job responsibilities

What You'll Bring To The Team

  • Strong spoken and written English B2+
  • 1+ Years of Experience in prior authorizations
  • 3+ Years of Experience in the healthcare industry
  • Experience with procedure authorizations in any medical field
  • Basic typing and keyboarding skills
  • Strong oral and written communication skills
  • Highly detail-oriented
  • Basic understanding of human anatomy, specifically musculoskeletal
  • Proficient use of CPT and ICD-10 codes

We Offer You

  • 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.
  • Great discount on lunch with our partnered restaurants

Job Type: Full-time

Application Question(s):

  • Could you please rate your English proficiency on a scale of 1 to 10?

Experience:

  • Prior Authorization: 1 year (Preferred)
  • Healthcare: 2 years (Preferred)
#J-18808-Ljbffr

  • Medellín, Antioquia, Colombia RVStaffing A tiempo completo

    _**RedValley,**_ the coolest and fastest-growing company, is seeking an experienced _ **Prior authorization specialist**_ to join our new medical team You will be responsible for obtaining pre-certifications and pre-authorizations for procedures and medications, scheduling appointments for outpatient testing with other providers, transcribing and triaging...


  • Medellín, Antioquia, Colombia RVStaffing A tiempo completo

    RedValley is seeking a skilled Prior Authorization Specialist to join our medical team. As a key member of our team, you will be 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...


  • Medellín, Antioquia, Colombia RVStaffing A tiempo completo

    Medical Authorization SpecialistWe are seeking an experienced Medical Authorization Specialist to join our team. The ideal candidate will have a strong understanding of medical policies and procedures, as well as excellent communication and organizational skills.Key Responsibilities:Review patient documentation to ensure medical policy guidelines are...

  • Insurance Specialist

    hace 2 meses


    Medellín, Antioquia, Colombia RVStaffing A tiempo completo

    **RedValley**, the fast-growing company in Medellín, is looking for a talented, and strategic, **on-site Insurance Specialist** to join one of our healthcare divisions. You will be responsible for managing the insurance claims process, verifying patient benefits, and obtaining prior authorizations for medical procedures and treatments. Your work will ensure...


  • Medellín, Antioquia, Colombia RVStaffing A tiempo completo

    Medical Authorization CoordinatorWe are seeking an experienced Medical Authorization Coordinator to join our team at RedValley. As a Medical Authorization Coordinator, you will be responsible for obtaining pre-certifications and pre-authorizations for procedures and medications, scheduling appointments for outpatient testing with other providers,...

  • Medical Biller

    hace 2 meses


    Medellín, Antioquia, Colombia New York Retina Center A tiempo completo

    Work remotely as a medical biller for an Ophthalmology private practice based in New York City. Must have billing experience and a superior work ethic. English and Spanish language skills and problem solving ability are a must. We use Nextech EMR and trizetto as our clearinghouse. Must be familiar with posting payments from ERA/EOB as well as sending...

  • Commission Specialist

    hace 5 días


    Medellín, Antioquia, Colombia ttg Talent Solutions A tiempo completo

    Job Title: Junior Commission SpecialistJob Summary:We are seeking a highly motivated and detail-oriented Junior Commission Specialist to join our team at ttg Talent Solutions. As a Junior Commission Specialist, you will play a crucial role in ensuring that sales teams are compensated accurately and in a timely manner.Key Responsibilities:Coordinate and...


  • Medellín, Antioquia, Colombia Rvstaffing A tiempo completo

    Quality Assurance SpecialistAt Rvstaffing, we are seeking a skilled Quality Assurance Specialist to ensure the highest standards of quality in our services. As a key member of our team, you will play a pivotal role in conducting thorough audits and analyses to guarantee exceptional service delivery.Key Responsibilities: Conduct routine audits and analysis of...


  • Medellín, Antioquia, Colombia CloudHire A tiempo completo

    Job Title: Inbound Support SpecialistWe are seeking a highly skilled and detail-oriented Inbound Support Specialist to join our CloudHire team. This role will play a crucial part in supporting our eCommerce websites and other warehouse channels.Key Responsibilities:Create digital packing slips in our warehouse management systemSolve Stocking PO tickets as...


  • Medellín, Antioquia, Colombia GroupM A tiempo completo

    Join GroupM Nexus as a Digital Campaign SpecialistAbout the Role:We are seeking a highly motivated and detail-oriented Digital Campaign Specialist to join our team at GroupM Nexus. As a key member of our HUB, you will be responsible for implementing processes to ensure the successful execution of digital campaigns in the US market.Key...


  • Medellín, Antioquia, Colombia Tesys Networks A tiempo completo

    Job Title: Customer Support and Network Surveillance SpecialistJob Summary:We are seeking a highly skilled Customer Support and Network Surveillance Specialist to join our team at Tesys Networks. The ideal candidate will have a strong background in network engineering and customer support, with excellent communication and problem-solving skills.Key...

  • Commission Specialist

    hace 2 semanas


    Medellín, Antioquia, Colombia ttg Talent Solutions A tiempo completo

    Job Summary: We are seeking a highly skilled Commission Specialist to join our team at ttg Talent Solutions. The successful candidate will be responsible for coordinating and executing commission processes, ensuring accurate and timely payment to sales representatives. Key Responsibilities: Process commissions on a weekly basis, maintaining accurate records...


  • Medellín, Antioquia, Colombia Genius Sports Group A tiempo completo

    About Genius Sports GroupWe are a leading sports technology company that is changing the way sports are played, watched, and bet on. We are looking for a talented Technical Support Specialist to join our team and help us deliver exceptional customer experiences.Job SummaryWe are seeking a highly skilled Technical Support Specialist to join our team. As a...

  • Policy Specialist

    hace 2 semanas


    Medellín, Antioquia, Colombia TaskUs A tiempo completo

    About TaskUsTaskUs is a leading provider of outsourced digital services and next-generation customer experience to fast-growing technology companies. Our mission is to help our clients represent, protect, and grow their brands by leveraging a cloud-based infrastructure and a team of highly skilled professionals.What We OfferAt TaskUs, we prioritize our...


  • Medellín, Antioquia, Colombia Premier Medical Associates (PMA) A tiempo completo

    Marketing and Administrative Support SpecialistWe are seeking a highly skilled Marketing and Administrative Support Specialist to join our team at Premier Medical Associates (PMA). As a key member of our marketing team, you will play a vital role in supporting and leading various marketing initiatives across multiple industries.Key Responsibilities:Develop...


  • Medellín, Colombia CloudHire A tiempo completo

    We are seeking a full-time Inbound Support & Reconciliation Specialist to work alongside our US-based Merchant Operations team. This role will support our eCommerce websites and other warehouse channels. Responsibilities: Creating digital packing slips in our warehouse management system. Solving Stocking PO tickets as assigned. Sending email...

  • Jr. Commission Specialist

    hace 2 semanas


    Medellín, Colombia ttg Talent Solutions A tiempo completo

    Position: Junior Commission Specialist Location: Medellín Work Arrangement: Hybrid Schedule: Monday to Friday, 7:30 a.m. to 5:00 p.m. Contract Type: Indefinite Term Salary: Commensurate with experience Description: A Junior Commission Specialist is an entry-level professional responsible for assisting with commission-related tasks...


  • Medellín, Antioquia, Colombia RVStaffing A tiempo completo

    RedValley is seeking a skilled Quality Assurance Specialist to ensure the highest standards of quality in our services. As a proactive and strategic professional, you will play a pivotal role in guaranteeing that our services meet established specifications and requirements.Key Responsibilities:Conduct routine audits and analysis of the quality of our...


  • Medellín, Antioquia, Colombia Genius Sports A tiempo completo

    About Genius SportsGenius Sports is a leading provider of sports technology solutions, serving some of the most prominent sports leagues in the United States.About the RoleWe are seeking a highly skilled Technical Support Specialist to join our technical team. As a Technical Support Specialist, you will be responsible for providing advanced technical...


  • Medellín, Antioquia, Colombia RVStaffing A tiempo completo

    RedValley is seeking a Quality Assurance Specialist to ensure the highest standards of quality in our services. As a proactive and strategic professional, you will play a pivotal role in guaranteeing that our services meet the established specifications and requirements.Key Responsibilities:Conduct routine audits and analysis of the quality of our...