Senior Prior Authorizations Specialist

hace 4 horas

Colombia RVStaffing A tiempo completo

_**RedValley,**_ the coolest and fastest-growing company, is seeking an experienced _**Senior 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 C1+
- 3+ 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.
- 50% discount on lunch with our partnered restaurant

Pay: $350,000,000 - $400,000,000 per month

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