Prior Authorization Specialist Job at Strategic Staffing Solutions, Detroit, MI

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  • Strategic Staffing Solutions
  • Detroit, MI

Job Description

STRATEGIC STAFFING SOLUTIONS (S3) HAS AN OPENING!



Strategic Staffing Solutions is currently looking for Prior Authorization Specialists for a contract opportunity with one of our largest clients located in Detroit, MI!



Title: Prior Authorization Specialists - multiple openings



Location: Detroit, MI



Duration: 12+ Months



Role Type: W2 contract engagement



ROLE SUMMARY



Medicare Advantage Post-Acute Care Specialist :

  • Support healthcare providers and UM reviewers with prior authorization requests for post-acute care services.
  • Includes manually entering authorization requests into healthcare system, following rules and algorithms embedded in the care management system to administratively approve prior authorization requests.
  • May work with providers to secure discharge plans, Notice of Non-Medical Coverage, Durable medical equipment, and other home supports required for discharge planning.
  • May support scheduling physician to physician calls.
  • Will support appeal processes for CMS designated Quality Improvement Organization appeals including logging all appeal activities.


Requirements:

  • High School Graduate or GED equivalent required.
  • Two (2) years of college preferred.
  • Two (2) years' experience as medical assistant, care technician, post-acute care and home health care support staff or ancillary services in other health care related field preferred.
  • Knowledge of post-acute care functions and processes or discharge readiness activities may be preferred for some positions.

Job ID: JOB-236034

Publish Date: 14 Jun 2024

Job Tags

Contract work,

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