Location: Marlborough,MA, USA
Adecco Healthcare & Life Sciences is hiring a remote contract Pre-authorization Specialist for our Medical partner based out of Marlborough, MA.
The anticipated wage for this position is between $24 and $26. Hourly wage may depend upon experience, education, geographic location, and other factors.
Benefit offerings include medical, dental, vision, life insurance, short-term disability, additional voluntary benefits, EAP program, commuter benefits and 401K plan. Our program provides employees the flexibility to choose the type of coverage that meets their individual needs. Available paid leave may include Paid Sick Leave, where required by law; any other paid leave required by Federal, State, or local law; and Holiday pay upon meeting eligibility criteria
The Pre-Authorization Specialist II is responsible for performing proficient benefit verification and pre-authorization functions with insurance carriers, within an established time frame, for new pre-surgical cases submitted to the Pre-Authorization Support Department.
**Responsibilities will include:**
Checking the departmental electronic inbox to coordinate the initial intake of physician and facility requests to secure prior authorization for service
Create electronic folders for new patients
Organize patient medical records in preparation for prior authorization and appeals process
Answers incoming calls received through the toll-free Pre-Authorization Support ACD and provides appropriate call/case handling
Performs benefit verification, pre-surgical authorization for new pre-surgical cases, and appeals by working closely with all payers
Utilizes proficient knowledge in Microsoft Office and database management to document case status, actions, and outcome
Communicates and builds relationships with HCP offices and Field Reimbursement Managers in regard to all inquiries for the handling of cases, i.e., missing case information, benefits etc.
Utilizes customer service skills in engaging with customers, communicating with sales representatives, and working in teams in a call center environment to expedite processing of cases
Coordinates with lead and supervisor regarding complicated cases
**Quality Systems Duties and Responsibilities:**
Build Quality into all aspects of their work by maintaining compliance to all quality requirements.
**Required qualifications:**
High School Diploma
Minimum 2-3-years of **recent** Insurance Pre-Authorization experience. Must have recent experience!
Experience working with various payors including, Medicare, Medicaid and Private Payor, as it relates to medical procedures, services, and devices
Experience building effective relationships with internal and external customers.
High speed internet and office home setting required.
Experience working remotely is preferred.
Must be willing to attend Teams video meetings.
Must have ability to troubleshoot technical issues remotely.
Must exhibit patience and professionalism.
**Pay Details:** $24.00 to $26.00 per hour
Benefit offerings available for our associates include medical, dental, vision, life insurance, short-term disability, additional voluntary benefits, EAP program, commuter benefits and a 401K plan. Our benefit offerings provide employees the flexibility to choose the type of coverage that meets their individual needs. In addition, our associates may be eligible for paid leave including Paid Sick Leave or any other paid leave required by Federal, State, or local law, as well as Holiday pay where applicable.
Equal Opportunity Employer/Veterans/Disabled
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The Company will consider qualified applicants with arrest and conviction records in accordance with federal, state, and local laws and/or security clearance requirements, including, as applicable:
+ The California Fair Chance Act
+ Los Angeles City Fair Chance Ordinance
+ Los Angeles County Fair Chance Ordinance for Employers
+ San Francisco Fair Chance Ordinance