What are the responsibilities and job description for the Prior Authorization Coordinator position at Auxiant?
https://www.auxiant.com/
Auxiant’s Mission Statement and Core Values
Mission:
An Independent TPA investing in People and Innovation to deliver expert-driven experiences with REAL Results.
Core Values: Independent Solutions. REAL Results
Respect
Empowerment
Agility
Leadership
Be part of a growing and prospering company as a Prior Authorization Coordinator. Auxiant is a third party administrator of self-funded employee benefit plans with offices in Cedar Rapids, IA, Madison and Milwaukee, WI. Auxiant is a fast-growing,progressive company offering an excellent wage and benefit package.
Job Summary:
The Prior Authorization Coordinator is responsible for the handling and tracking of medical necessity review requests received.
Essential Functions:
- Review plan document language to determine if a requested service is eligible under the health plan
- Forward documentation to the appropriate vendor for medical necessity review
- Draft and send response letters based on interpreting medical necessity determination received from outside vendor
- Track medical necessity reviews internally and by using vendor portals
- Run and review various reporting
- Assist with department questions
- Review Single Case Agreement requests
Nonessential Functions:
- Other duties as assigned or appropriate
Education/Qualifications:
- Understanding of medical terminology
- Familiarity with ICD10 and HCPCS/CPT codes
- 1 year medical experience preferred
- 1 year data entry experience and QicLink experience
- Proficient PC skills including e-mail, record keeping, routine database activity, word processing, spreadsheet,10-key
- Proven experience in a professional office environment
- High school diploma and 1-2 years related experience; or equivalent combination of education and experience.
- Full benefits including: Medical, Dental, Vision, Flexible Spending, Gym Membership Reimbursement, Life Insurance, LTD, STD, 401K, 3 weeks vacation, 9 paid holidays, casual dress code and more
Job Type: Full-time
Schedule:
- 8 hour shift
- Day shift
- Monday to Friday