Works with the utilization management team to support the prior authorization request process and ensure authorization requests are addressed within contractual timelines.
Responsible for tracking, maintaining, and documenting authorization requests for services, verifying coverage and benefit eligibility, routing requests to the appropriate clinical reviewer, and supporting timely adjudication. Researches health plan providers and policies, maintains referral documentation, and helps ensure authorizations are handled accurately and efficiently.
Serves as a subject matter expert for the overall authorization process and supports multiple service types at different urgency levels. Must remain current on healthcare authorization processes, policies, and procedures.
Required
- High school diploma or GED
- 2–4 years of related experience
- Strong knowledge of medical terminology and insurance
- Ability to perform accurate data entry and maintain detailed records
- Must be authorized to work in the U.S. without current or future visa sponsorship
- Must be located in the greater Little Rock, AR area
Responsibilities
- Track and maintain authorization requests
- Verify insurance coverage and service/benefit eligibility
- Document referrals and authorization activity
- Research providers, policies, and referral requirements
- Support clinical reviewers with necessary medical information
- Maintain timely communication with providers and reviewers
Competitive pay, health insurance, 401(k) and stock purchase plans, tuition reimbursement, paid time off, holidays, and flexible work schedules including remote, hybrid, field, or office options.
Location
Arkansas, US
Employment Type
Full-time
Experience Level
Associate
Remote work allowed
Yes
Posted
1 month ago