Job description

AUTHORIZATION SPECIALIST

McGregor PACE, a Program of All-inclusive Care for the Elderly (PACE site) has an employment opportunity for an experienced full-time Authorization Specialist at our Forest Hills office location. The incumbent will provide administrative support to providers managing the authorization process from initial requests to authorization for all assigned cases.

We are seeking a qualified candidate with excellent customer service skills and the ability to function in a fast-paced clinic setting.

Job Requirements: Must provide open communication with administrative staff, hospitals and medical outpatient offices regarding the status of authorization requests, authorizations and related topics.

Review authorization requests for all Contracted entities and notify providers, billing when issues are present.

Send authorizations timely to prevent delay billing and/or denial of payment.

Prepare and complete prior authorization request forms and apply appropriate guidelines to prior authorizations request.

Determine when request does not meet PACE guidelines and coordinate appropriate follow up by clinical staff members that aid in the prior authorization process.

Follow-up with appropriate parties to meet deadlines and prevent authorization delays.

Must possess good computer skills, customer service skills to manage a high volume of phone calls, ability to process with timely follow up as needed

Qualifications:

• High School diploma or equivalent required.
• Strong organizational skills with attention to detail; ability to meet timelines
• Must demonstrate ability to effectively build relationships with both internal and external customers.
• Must be able to accurately document and verbalize issues and have the ability to work in a team environment and across departments.
• Work well in fast pace office environment
• Computer proficiency in MS office
• Excellent customer service experience
• Physical ability to perform job functions
• Valid Ohio driver license. Physical, background check
• Prior health care experience preferred

GREAT BENEFITS PACKAGE that includes Health insurance, Health Savings Account, Dental, Vision, Employer paid Life Insurance, Voluntary Life, STD/LTD, matching 403b Retirement Plan, Paid Time Off, Holidays and Sick Time!

Submit your resume with salary requirements right away or apply in person at:

14800 Private Dr., East Cleveland, OH 44112

Job Type: Full-time

Pay: $16.00 - $17.50 per hour

Benefits:

• Dental insurance
• Disability insurance
• Employee assistance program
• Employee discount
• Health insurance
• Health savings account
• Life insurance
• Paid time off
• Retirement plan
• Tuition reimbursement
• Vision insurance

Schedule:

• 8 hour shift
• Day shift
• Monday to Friday
• No weekends
• Overtime

COVID-19 considerations:
McGregor PACE complies with CDC guidelines for the mitigation of Covid 19 to include mandated vaccination, symptom monitoring, wearing masks, frequent handwashing/sanitizing and social distancing.

Education:

• High school or equivalent (Required)

Experience:

• Computer skills: 1 year (Required)
• working with frail older persons: 1 year (Required)
• Customer service: 1 year (Required)
• clinic / hospital: 2 years (Preferred)

Work Location: In person

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