Job Description

**Overview** BroadPath is hiring **Prior Authorization Specialist** to work remotely from home. Our **Prior Authorization Specialist** is responsible for reviewing and resolving authorization requests and communicating resolution to the appropriate parties in accordance with the standards and requirements established by the Centers for Medicare and Medicaid. **Responsibilities** + Process authorization requests from intake for completeness and possible approval based on available criteria + Research issues utilizing systems and other available resources + Assures timeliness and appropriateness of requests according to state, federal and healthcare guidelines + Approve/fund requests if available information aligns with criteria + Route requests for clinical review as indicated + Creates and/or maintains statistics and reporting **Qualifications** + High school diploma or equivalent + 1 year of health claims experience, OR one year of customer service/provider service experience in a managed care or healthcare environment + Ability to toggle through multiple systems + Strong verbal and written communication skills + Processing Authorizations with Medicare Part C or D experience + Basic knowledge of medical terminology, computer literacy, and proficient keyboarding skills are required **Diversity Statement** _At BroadPath, diversity is our strength. We embrace individuals from all backgrounds, experiences, and perspectives. We foster an inclusive environment where everyone feels valued and empowered. Join us and be part of a team that celebrates diversity and drives innovation!_ _Equal Employment Opportunity/Disability/Veterans_ _If you need accommodation due to a disability, please email us at [email protected]. This information will be held in confidence and used only to determine an appropriate accommodation for the application process_ _BroadPath is an Equal Opportunity Employer. We do not discriminate against our applicants because of race, color, religion, sex (including gender identity, sexual orientation, and pregnancy), national origin, age, disability, veteran status, genetic information, or any other status protected by applicable law._ **_Compensation:_** _ _ _BroadPath has an effective process for assessing market data and establishing ranges to ensure we remain competitive. You are paid within the salary range based on your experience and market data of the position. The actual salary for this role may vary by location._

Job Tags

Remote job, Work from home,

Similar Jobs